The use of molecular markers (Ki67 & p53) in premalignant and malignant cervical neoplasms
Abstract
Introduction: Cervical cancers are the second most frequent type of cancer in females. It develops from premalignant to invasive stages in a multistep process of carcinogenesis. The differentiation between cervical intraepithelial neoplasia III (CIN III) and early squamous cell carcinoma (SCC) of the cervix could be difficult to diagnose in certain situations unless we see the invasion. The objective of the study was to determine the expression of p53 & Ki67 in CIN and cervical cancers and its correlation with grading and differentiation of cervical cancers with special emphasis on whether the use of Ki67 & p53 markers could help in differentiating CIN III from early SCC.
Material and Methods: A prospective study on 90 cases of cervical biopsies, including- cases of : chronic cervicitis (40), CIN III (19) and invasive carcinoma (31). All cases were evaluated by immunohistochemistry using Ki67 & p53 monoclonal antibodies.
Results: Both Ki67 & p53 showed higher expression in CIN III and invasive cervical carcinoma than chronic cervicitis with statistically significant difference p<0.01 and p<0.001 respectively. High significant difference of p53 & Ki67 expression was found between patients with CIN III and invasive cervical carcinomas. There was a clear trend for increasing number of cases with positive Ki67 & p53 index with increasing grades of cervical cancer.
Conclusion: Ki67 & p53 showed increased expression from CIN III to SCC and it may be helpful adjunct in differentiating these two lesions. These markers could be used as biomarkers in the evaluation of the proliferative activity and progressive potential of dysplastic and neoplastic changes.
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