Negri Giovanni, Bellisano Giulia, Zannoni Gian Franco, Rivasi Francesco, Kasal Armin, Vittadello Fabio, Antoniazzi Sonia, Faa Gavino, Ambu Rossano, Egarter-Vigl Eduard
Department of Pathology, Central Hospital Bolzano, Bolzano, Italy.
Am J Surg Pathol. 2008 Nov;32(11):1715-20. doi: 10.1097/PAS.0b013e3181709fbf.
As only a minority of low-grade dysplastic lesions of the cervix uteri will eventually progress to carcinoma, predicting the behavior of these lesions could be of high value in clinical practice. The aim of the study was to evaluate p16 ink4a and L1 as immunohistochemical markers of the biologic potentiality of low-grade dysplasia of the uterine cervix. The study included 38 conization specimens with coexisting cervical intraepithelial neoplasia grade 1 (CIN1) and 3 (CIN3) (group A) and 28 punch biopsies from women with CIN1 and proven spontaneous regression in the follow-up (group B). In group A, all CIN3 were p16 ink4a positive (p16+) and L1 negative (L1-). The CIN1 of this group were p16+L1- and p16+L1+ in 68.42% and 31.57%, respectively. No other expression pattern was found in this group. In group B, the p16+L1-, p16+L1+, p16-L1+, and p16-L1- patterns were found in 3.57%, 25%, 14.29%, and 57.14%, respectively. Overall, 96.29% p16+L1- CIN1 were found in group A, whereas all the p16-L1+ and p16-L1- CIN1 were found in group B. A significant difference between staining pattern distributions of group A and B was observed (P<0.0001). The results of the study show that p16 ink4a and L1 immunohistochemistry can be helpful for estimating the biologic potentiality of low-grade squamous cervical lesions. Particularly in cases in which the grade of the lesion is morphologically difficult to assess, the p16/L1 expression pattern could be useful for planning the clinical management of these women.
由于只有少数子宫颈低度发育异常病变最终会发展为癌，因此在临床实践中预测这些病变的行为可能具有很高的价值。本研究的目的是评估p16 ink4a和L1作为子宫颈低度发育异常生物学潜能的免疫组织化学标志物。该研究包括38例同时存在宫颈上皮内瘤变1级（CIN1）和3级（CIN3）的锥形切除标本（A组）以及28例来自CIN1且在随访中证实有自发消退的女性的活检标本（B组）。在A组中，所有CIN3均为p16 ink4a阳性（p16+）且L1阴性（L1-）。该组的CIN1中，p16+L1-和p16+L1+分别占68.42%和31.57%。该组未发现其他表达模式。在B组中，p16+L1-、p16+L1+、p16-L1+和p16-L1-模式分别占3.57%、25%、14.29%和57.14%。总体而言，A组中96.29%的CIN1为p16+L1-，而所有p16-L1+和p16-L1-的CIN1均在B组中。观察到A组和B组染色模式分布存在显著差异（P<0.0001）。研究结果表明，p16 ink4a和L1免疫组织化学有助于评估子宫颈低度鳞状病变的生物学潜能。特别是在病变分级在形态学上难以评估的情况下，p16/L1表达模式可能有助于规划这些女性的临床管理。
