Cabibi Daniela, Napolitano Caterina, Giannone Antonino Giulio, Micciulla Maria Carmela, Porcasi Rossana, Lo Coco Roberta, Bosco Liana, Vinciguerra Manlio, Capra Giuseppina
Anatomic Pathology Unit, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
Section of Biology and Genetics, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D), University of Palermo, 90127 Palermo, Italy.
Diagnostics (Basel). 2021 Oct 20;11(11):1947. doi: 10.3390/diagnostics11111947.
P16 immunostaining is considered a useful surrogate of transcriptionally active high-risk (hr) HPV infection. Only strong and widespread "block-like" immunoreactivity is considered specific, whereas weak/focal p16 positive immunostaining is considered not specific, and follow-up and HPV molecular detection is not indicated. The aim of the study was to evaluate the presence of HPV DNA and Ki67 immunostaining in 40 cervical atypical biopsies (CALs) with mild and focal histological features suggestive of HPV infection-20 cases with weak/focal p16 positive immunoreactivity and 20 cases negative for p16 expression. In 16/20 weak/focal p16 positive CALs (80%), the INNO-LiPA HPV genotyping detected hrHPV genotypes (HPV 31, 51, 56, 59, 26, 53, 66, 73, and 82). Co-infection of two or more hrHPV genotypes was often evidenced. HPV16 and 18 genotypes were never detected. Ki67 immunostaining was increased in 10/20 cases (50%). In 19/20 p16 negative CALs, hrHPV infection was absent and Ki67 was not increased. These results suggest that weak/focal p16 immunostaining represents the early stage of transcriptionally active infection, strongly related to the presence of less common hrHPV genotypes, probably with a slower transforming power, but with a potential risk of progression if the infection persists. HPV DNA genotyping and follow-up could be useful in these cases to verify if they are able to evolve into overt dysplastic changes and to improve knowledge of less common hrHPV genotypes.
P16免疫染色被认为是转录活跃的高危（hr）人乳头瘤病毒（HPV）感染的一种有用替代指标。只有强烈且广泛的“块状”免疫反应性被认为具有特异性，而弱阳性/局灶性p16阳性免疫染色则被认为不具有特异性，无需进行随访和HPV分子检测。本研究的目的是评估40例宫颈非典型活检（CALs）中HPV DNA的存在情况以及Ki67免疫染色情况，这些活检具有轻度和局灶性组织学特征，提示HPV感染——20例为弱阳性/局灶性p16阳性免疫反应性，20例p16表达阴性。在20例弱阳性/局灶性p16阳性的CALs中，有16例（80%）通过INNO-LiPA HPV基因分型检测到hrHPV基因型（HPV 31、51、56、59、26、53、66、73和82）。经常发现两种或更多hrHPV基因型的合并感染。从未检测到HPV16和18基因型。20例中有10例（50%）Ki67免疫染色增强。在20例p16阴性的CALs中，有19例未检测到hrHPV感染，且Ki67未增强。这些结果表明，弱阳性/局灶性p16免疫染色代表转录活跃感染的早期阶段，与较不常见的hrHPV基因型的存在密切相关，其转化能力可能较慢，但如果感染持续存在则有进展的潜在风险。HPV DNA基因分型和随访在这些病例中可能有用，以验证它们是否能够演变为明显的发育异常变化，并增进对较不常见的hrHPV基因型的了解。
