Correlation of immunohistochemical expression of p16, Ki-67, and p53 with histopathological diagnosis of noninvasive cervical lesions: A multicenter study from South East Nigeria

Abstract

Background: There is a high burden of cervical cancer in our environment. Most patients present late when the prognosis is guarded. Hence, accurate diagnosis of preinvasive lesions from cervical biopsies is important for clinical decisions and patient management. The aim of the study is to correlate the expression of p16INK4a, p53, and Ki-67 with histopathological diagnosis of noninvasive cervical lesions. Materials and Methods: The paraffin blocks of all cervical biopsies (excluding cases histologically diagnosed as invasive lesions) seen in two histopathology laboratories in Nnewi, Southeast Nigeria, over a 10-year period (2011–2020) were retrieved from the archives of both facilities. The cases were subjected to immunohistochemistry using p16INK4a, Ki-67, and p53 monoclonal antibodies. Results: There were 23 normal/reactive (45.1%), 6 low-grade squamous intraepithelial lesion (11.8%), and 22 hIL (43.1%). There is a very strong positive correlation between p16INK4a expression and the histopathological diagnosis (Spearman's correlation = 0.98). There is a strong positive correlation between Ki-67 expression and the histopathological diagnosis (Spearman's correlation = 0.70). There is a weak positive correlation between p53 expression and histopathological diagnosis (Spearman's correlation coefficient = 0.40). Conclusion: p16INK4a shows the best correlation with histopathological diagnosis of noninvasive cervical lesions and may be a very useful adjunct to H and E for diagnosing preinvasive cervical lesions. However, p53 correlates poorly with histopathologically diagnosed noninvasive cervical lesions and therefore may not be diagnostically useful.