Expression of the oncoproteins p16, p53 and Ki67 as predictive value in the differentiation of low-grade intracervical neoplasms of high and low risk

Background: The cytological characteristics of the precursors of squamous carcinoma of the cervix are divided into two groups: the low-grade squamous intraepithelial lesions (LSIL or LGSIL) and the high-grade squamous intraepithelial lesions (HSIL or HGSIL). We also observed the immunocytochemical characteristics of ASC-US (anomaly of squamous cells of intermediate significance). Methods: The study is based on the observation of 1367 ThinPrep pap tests. The population is represented by the subjects belonging to the LILT (League for the Fight against Cancer - Provincial Section of Avellino), without strict selection criteria (random). Low-grade lesions, including ASC-US and L-SIL, were tested with antibodies (Ki67, pl6 and p53) for the possible selection of cases with high and low risk of transformation into cancer. Results: In 18 months, 1367 Thin Prep were reviewed and among them, 98% were diagnosed as negative while 2% were positive for intraepithelial lesions. Specifically, 31 cases diagnosed as positive were: 5 (16%) ASC-US; 2 (6%) ASC-H; 19 (62%) L-SIL; 3 (10%) H-SIL; 1 (3%) carcinoma and 1 case of AGC (3%). Conclusions: The most common diagnoses were of ASC-US and L-SIL (HPV correlated). The cases diagnosed as ASC-US showed a range of ages from 27-45 years while L-SIL lesions from 23-55 years. In the present work both lesions with an indeterminate significance and low-grade intraepithelial lesions were considered.