Importance of p16 and Ki-67 Expression in the Presence of Human Papillomavirus in Adenocarcinoma of the Uterine Cervix
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In recent years, the incidence of cervical adenocarcinoma has increased. The role of human papillomavirus (HPV) infection in cervical carcinoma is well established. The aim of this study was to investigate the possible correlation between the expression of cell cycle-associated proteins and HPV infection in cervical adenocarcinomas. We analyzed the expression of p16, p53, and Ki-67 in 68 cases of <I>in situ</I> and invasive cervical adenocarcinomas by immunohistochemistry. These cases were divided into high and low expression groups based on immunohistochemical staining data. High p16 expression was seen in 29 of 30 (96%) HPV-DNA-positive cases shown to be HPV-DNA positive by polymerase chain reaction (PCR), and in 26 of 27 (96%) cases shown to be HPV-DNA positive by <I>in situ</I> hybridization (ISH) . In 50 cases of stage I b and stage II adenocarcinomas, statistical analysis showed a highly significant differences between the high expression of p16 and the HPV-positivity by ISH (<I>P</I>=0.003) and PCR (<I>P</I>=0.001) . High expression of Ki-67 also showed a strong relation with HPV-Positivity by ISH (<I>P</I>=0.002) . Patients in whom a high expression of p16 was observed had a lower recurrence rate than patients with a low expression of p16 (<I>P</I>=0.028) . Cases with a high expression of Ki-67 showed a better prognosis than those with a low expression of Ki-67 (<I>P</I>=0.024) . P16 and Ki-67 are useful biomarkers for HPV-DNA-positive cervical adenocarcinomas, which are easily monitored by immunohistochemical staining.
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