Modern interdisciplinary monitoring of cervical cancer risk

Vol. 60 No. 2, 2019

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Mihaela Badea, Alexandru Baros, Roxana Elena Bohiltea, Irina Ecaterina Julea, Florentina Ligia Furtunescu, Anca-Maria Istrate-Ofiteru, Larisa Iovan, Monica Mihaela Cirstoiu, Miruna Ruxandra Burcin, Natalia Turcan, Adrian Neacsu, Costin Berceanu

Currently, Romania ranks first in Europe with regard to cervical cancer mortality. A new solution proposed for optimizing cytology-based screening, before seeing the risk associated with minor abnormalities results, is the use of molecular markers. This study concerns atypical squamous of undetermined significance (ASC-US) results, the grey zone of cytology that hides up to 15% high-grade lesions, to see how dual immunocytochemistry (ICC) staining for p16INK4a/Ki67 help to better identify and manage high-risk (HR) ASC-US patients. We included and reviewed 183 cases with ASC-US results and p16INK4a/Ki67 double staining (DS) performed in MICOMI Clinic (Bucharest) during 2014-2016. All patients were referred for colposcopy and biopsy if appreciated as necessary and followed-up at six and 12 months. One DS(+)/HR human papillomavirus (HPV) negative case was positive for HPV73 Group IIB International Agency for Research on Cancer (IARC). The mean age for ASC-US in our study group was 32 years, with a median of 31 years and 31% of patients were aged 25-29 years. The sensibility of p16INK4a/Ki67 double immunostaining was 100%, the specificity 88%, the positive predictive value (PPV) was 82%, and the negative predictive value (NPV) was 100%. The use of p16INK4a/Ki67 ICC test optimizes the medical approach towards screening or monitoring especially in ASC-US HR HPV(+) young patients, unnecessary colposcopies are avoided thus invasive gestures at nulliparous are limited.

Corresponding author: Roxana Elena Bohiltea, Lecturer, MD, PhD; e-mail: r.bohiltea@yahoo.com; Alexandru Baros, Assistant Professor, MD, PhD; e-mail: alexandrubaros@yahoo.com

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