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Association of p16 and Ki-67 with Risk of Recurrence in Previously Treated Cervical High-Grade Squamous Intraepithelial Lesions

Authors
  • Arredondo-Gálvez, Carlos Germán
  • Acuña-González, Denise
  • Cantú-de-León, David
  • Chanona-Vilchis, José Gregorio
  • Avilés-Salas, Alejandro
  • González-Enciso, Aarón
  • Bandala-Jaques, Antonio
  • Barquet-Muñoz, Salim Abraham
Type
Published Article
Journal
Gynecologic and Obstetric Investigation
Publisher
S. Karger AG
Publication Date
Jun 10, 2021
Volume
86
Issue
3
Pages
293–298
Identifiers
DOI: 10.1159/000515894
PMID: 34111875
Source
Karger
Keywords
Disciplines
  • Research Article
License
Green
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Abstract

Objective: Our main objective was to assess the association between the markers p16 and Ki-67 and recurrence of disease in patients previously treated for cervical high-grade squamous intraepithelial lesion (HSIL). Design: This is a case-control study at the National Cancer Institute conducted between 2005 and 2015. Of the patients with a pathologically confirmed diagnosis of HSIL, 107 cases were selected. They were divided into 2 groups: 28 cases with recurrence after treatment and a control group of 79 patients without recurrence. We identified clinical, pathological, and treatment variables. Methods: Two experienced pathologists performed immunohistochemical analysis of biomarkers; they agreed on their interpretation, and we calculated the odds ratios (ORs) associated with recurrence. For group comparisons, we used the Wilcoxon signed-rank, χ<sup>2</sup>, or Fisher’s exact test, depending on the type of variable. We conducted logistic regression models to estimate ORs and determine the factors associated with recurrence. The recurrence-free period was defined as the time frame between conization and either recurrence of disease or the last date the patient was seen. We used Kaplan-Meier plots to visualize survival curves and log-rank tests to compare the curves. We established a p value <0.05 as statistically significant. Results: After pathologists performed immunohistochemical analysis, they achieved an agreement level of 83.7% for p16 and 60% for Ki-67. We did not find an association between recurrence and either p16 expression (p = 0.69) or the percentage of Ki-67 expression (p = 0.71). The recurrence-free period analysis did not reveal a difference in p16 expression (p = 0.57) nor in the percentage of Ki-67 expression in the 3-tiered scale (p = 0.56). Limitations: Our main limitation was a reduced sample size. Conclusion: We found no association between p16 and Ki-67 positivity and the risk of recurrence in previously treated HSIL.

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