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Mem. Inst. Oswaldo Cruz ; 107(5): 571-577, Aug. 2012. ilus, tab
Article Dans Anglais | LILACS | ID: lil-643740

Résumé

Although several studies have evaluated the role of p16INK4a as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16INK4a in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16INK4a as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16INK4a was performed in 326 cervical tissue microarray specimens. Performance indicators were calculated and compared using receiving operating characteristics curve (ROC)/area under the curve. In HIV-1-negative women, the percentage of cells that was positive for p16INK4a expression was significantly correlated with the severity of CIN (p < 0.0001). A ROC curve with a cut-off value of 55.28% resulted in a sensitivity of 89%, a specificity of 81%, a positive predictive value of 91% and a negative predictive value of 78%. HIV-seropositive women exhibited decreased expression of p16INK4a in CIN2-3 specimens compared with HIV-negative specimens (p = 0.031). The ROC data underscore the potential utility of p16INK4a under defined conditions as a diagnostic marker for CIN 2-3 staging and invasive cervical cancer. HIV-1 infection, however, is associated with relatively reduced p16INK4a expression in CIN 2-3.


Sujets)
Adulte , Femelle , Humains , Adulte d'âge moyen , Dysplasie du col utérin/diagnostic , /métabolisme , Marqueurs biologiques tumoraux/métabolisme , Tumeurs du col de l'utérus/diagnostic , Études cas-témoins , Dysplasie du col utérin/complications , Dysplasie du col utérin/métabolisme , Infections à VIH/complications , VIH-1 (Virus de l'Immunodéficience Humaine de type 1) , Immunohistochimie , Réaction de polymérisation en chaîne , Valeur prédictive des tests , Courbe ROC , Sensibilité et spécificité , Tumeurs du col de l'utérus/complications , Tumeurs du col de l'utérus/métabolisme
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