Demographic characteristics, risk factors and immunocytochemistry of p16INK4a, Ki-67, MCM5, and survivin as predictors for the progress of cervical precancer lesion
DOI:
https://doi.org/10.13181/mji.v19i3.398Keywords:
case control study, equation, HPV DNAAbstract
Aim To identify the predictive factors and biomarkers in the progression of cervical precancer lesion or Cervical Intraepithelial Neoplasia (CIN).
Methods The study was conducted from August 2007 to September 2008. Design of the study was case-control with stratifications of test dose response. The cases were patients with CIN. Control patients were non CIN patients. Bivariate analysis followed by multivariate analysis was conducted.
Results There were 130 patients, consisting of 124 CIN patients divided into CIN 1, CIN 2 and CIN 3, with the following numbers of patients: 30, 41, and 33, respectively and 26 patients without CIN (non CIN). Bivariate analysis showed that age < 41 years, education ≥13 years, sexual partner ≥2, first sexual relationship at age < 22 years, smoking, the presence of sexuallly transmitted infections, positive HPV DNA, high p16INK4a, Ki-67, MCM5 and Survivin expression constituted independent variables for the occurrence of CIN with P value of < 0.05. However, on multivariate analysis, independent variables that emerged were age, education ≥13 years, sexual partner ≥2 persons, positive HPV DNA, and over expression of p16INK4a, Ki-67 and Survivin that showed a P value of < 0.005.
Conclusion Younger ages, education age ≥13 years, sexual partner ≥2 persons, positive HPV DNA, high p16INK4a, Ki-67 and Survivin expression constituted the risk factors for the occurrence of the progress of CIN, and was used in the equation to predict the progress of cervical precancer lesion. (Med J Indones 2010;19:147-53)
Downloads
References
von Knebel DM. New markers for cervical dysplasia to visualise the genomic chaos created by aberrant oncogenic papillomavirus infections. Eur J Cancer. 2002; 38: 2229-42.
Redman R, Rufforny I, Liu C, Wilkinson EJ, Massoll NA. The utility of p16(Ink4a) in discriminating between cervical intraepithelial neoplasia 1 and nonneoplastic equivocal lesions of the cervix. Arch Pathol Lab Med. 2008; 132: 795-9.
Negri G Egarter Vigl E KA. p16INK4a is a usefull marker for the diagnosis of adenocarcinoma of the cervix uteri and its precursors : an imunohistochemical study with imunocytochemical correlations. Am J Surg Pathol. 2003; 27:187-93.
Sahebali S, Depuydt CE, Segers K et al. Ki-67 immunocytochemistry in liquid based cervical cytology: useful as an adjunctive tool? J Clin Pathol. 2003; 56: 681-6.
Schluter C, Duchrow M, Wohlenberg C, Becker MHG, Key G. The cell proliferation associated antigen of antibody Ki-67: A very large, ubiquitous nuclear protein with numerous repeated elements, representing a new kind of cell cycle maintaining proteins. J Cell Biol. 1993; 123: 513-22.
Sarian LO, Derchain SF, Yoshida A et al. Expression of cyclooxygenase-2 (COX-2) and Ki67 as related to disease severity and HPV detection in squamous lesions of the cervix. Gynecol Oncol. 2006; 102: 537-41.
Murphy N, Ring M, Heffron CC et al. p16INK4A, CDC6, and MCM5: predictive biomarkers in cervical preinvasive neoplasia and cervical cancer. J Clin Pathol. 2005; 58: 525-34.
Lanham S, Herbert A, Watt P. HPV detection and measurement of HPV-16, telomerase, and survivin transcripts in colposcopy clinic patients. J Clin Pathol. 2001; 54: 304-8.
Reed JC. The Survivin saga goes in vivo. J Clin Invest. 2001; 108: 965-9.
Zulham. Survivin expression in exfoliative cells in normal pap smear, precancer lesion and post therapy cervical cancer. [In indonesian] [Thesis]. Jakarta: FKUI; 2008.
Bibbo M, Klump WJ, DeCecco J, Kovatich AJ. Procedure for immunocytochemical detection of P16INK4A antigen in thin-layer, liquid-based specimens. Acta Cytol. 2002; 46: 25-9.
Madiyono B, Moeslichan S, Sastroatmoro S, Budiman I, Purwanto HS. Perkiraan besar sampel. In: Sarstroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 3rd edition. Jakarta: Sagung Seto; 2008. p. 310-20.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with Medical Journal of Indonesia agree to the following terms:
- Authors retain copyright and grant Medical Journal of Indonesia right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial License that allows others to remix, adapt, build upon the work non-commercially with an acknowledgment of the work’s authorship and initial publication in Medical Journal of Indonesia.
- Authors are permitted to copy and redistribute the journal's published version of the work non-commercially (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Medical Journal of Indonesia.
