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Hyesun Kim 1 Article
The Utility of p16INK4a and Ki-67 as a Conjunctive Tool in Uterine Cervical Lesions
Sangho Lee, Hyunchul Kim, Hyesun Kim, Chulhwan Kim, Insun Kim
Korean J Pathol. 2012;46(3):253-260.   Published online June 22, 2012
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AbstractAbstract PDF

Immunohistochemical staining for p16INK4a and Ki-67 has been used to improve the accuracy in making a diagnosis of the uterine cervix cancer on biopsy. This study was conducted to examine the usefulness of these markers in the pathological diagnosis based on cervical biopsy.


We selected a consecutive series of 111 colposcopically directed cervical punch biopsies. Using these biopsy samples, we performed an immunohistochemical staining for p16INK4a and Ki-67 to establish a diagnosis. The slides were circulated among four pathologists in a sequential order: the hematoxylin and eosin (H&E) slide, H&E slide and p16INK4a-stained slide, and H&E slide, p16INK4a- and Ki-67-stained slides.


The overall rates of the concordance in the first, the second, and the third diagnoses were 77.5%, 82.0%, and 82.0%, respectively. The rate of the concordance in the diagnosis of cervical intraepithelial neoplasm (CIN) 2/3 was increased from 62.2% to 73.0%. But there was a variability in the rate of the revision of the diagnosis between the pathologists. With the application of criteria for interpreting the expressions of p16INK4a and Ki-67, benign and CIN 1 lesions showed a p16INK4a expression score of 0 or 1. But CIN 2 and CIN 3 lesions showed a p16INK4a expression score of 2 and 3, respectively.


The immunostain for p16INK4a and Ki-67 might be useful in reducing an inter-observer variability. But criteria for interpreting both markers should be strictly applied.


Citations to this article as recorded by  
  • Possible role of negative human papillomavirus E6/E7 mRNA as a predictor of regression of cervical intraepithelial neoplasia 2 lesions in hr-HPV positive women
    Maria Teresa Bruno, Nazario Cassaro, Salvatore Giovanni Vitale, Arianna Guaita, Sara Boemi
    Virology Journal.2022;[Epub]     CrossRef
  • Evaluation of p16, human papillomavirus capsid protein L1 and Ki-67 in cervical intraepithelial lesions: Potential utility in diagnosis and prognosis
    Hanan AlSaeid Alshenawy
    Pathology - Research and Practice.2014; 210(12): 916.     CrossRef
  • Distribution of Human Papillomavirus 52 and 58 Genotypes, and Their Expression of p16 and p53 in Cervical Neoplasia
    Tae Eun Kim, Hwal Woong Kim, Kyung Eun Lee
    Korean Journal of Pathology.2014; 48(1): 24.     CrossRef
  • Detection and pathological value of papillomavirus DNA and p16INK4A and p53 protein expression in cervical intraepithelial neoplasia
    Oncology Letters.2014; 7(3): 738.     CrossRef
  • p16INK4a Immunohistochemistry in Cervical Biopsy Specimens
    Miriam Reuschenbach, Nicolas Wentzensen, Maaike G. Dijkstra, Magnus von Knebel Doeberitz, Marc Arbyn
    American Journal of Clinical Pathology.2014; 142(6): 767.     CrossRef

JPTM : Journal of Pathology and Translational Medicine