Determining the Role of Ki67 and p16INK4a Biomarkers on Conventional Cell Blocks to Differentiate Post Radiation Dysplasia from Cervical Cancer in Post Therapeutic Surveillance Cytology | Chapter 02 | Issues and Developments in Medicine and Medical Research Vol. 2

 Introduction: Although pap tests are successful in detecting abnormal cervical cytology prior to treatment, they are ineffective after treatment due to radiation-induced alterations. Post-therapy Papanicolaou (pap) tests have a low diagnostic accuracy because it is difficult to distinguish benign from malignant lesions due to post-radiation cellular alterations, also known as post-radiation dysplasia.

The usefulness of the biomarkers p16INK4a and Ki67on conventional cell blocks (CCBs) in post-therapeutic surveillance of cervical cancer to detect residual disease and site recurrence was investigated in this work. We've also looked into using CCBs as a key screening tool.

Patients who were diagnosed with cervical cancer less than a year ago were followed in this cross-sectional study between April 2018 and April 2019. For CCBs, we used typical pap smears and samples in 10% neutral buffered formalin. Ki67 and p16INK4a were used as primary antibodies in immunohistochemistry on all cell blocks.

Recurrences and residual disease were identified in 8 patients out of a total of 35. For detecting cervical cancer, pap, cell blocks, and p16INK4a had sensitivity, specificity, and diagnostic accuracy of 75 percent, 74.07 percent, and 88.57 percent; 100 percent, 88.89 percent, 91.43 percent; and 37.50 percent, 96.30 percent, and 82.86 percent, respectively. We discovered that the Ki67 labelling index of 20% had a diagnostic accuracy of 100%.

Conclusion: Ki67 labelling index of 20% on CCBs may distinguish persistent and recurrent cancer from post-radiation dysplasia in post-therapy surveillance cytology (p value 0.001). In addition, we discovered that CCBs have a higher diagnostic accuracy than pap tests (Mac Nemar p value, 0.027). We did not find p16INK4A to be very beneficial as a biomarker for recurrence/residual illness evaluation.

Author(S) Details

F. S. Desai
Department of Surgical Pathology, Himalaya Cancer Hospital and Research Center, Vadodara, Gujarat, India.

Rajesh Korant
Department of Radiation Oncology, Himalaya Cancer Hospital and Research center, Vadodara, Gujarat, India.

Mehul Gohil
Department of Radiation Oncology, Himalaya Cancer Hospital and Research center, Vadodara, Gujarat, India.

Lisam Shanjukumar Singh
Department of Biotechnology, Cancer Biology Division, Manipur University, Imphal, Manipur, India.

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