Predictive Value of Marker of Proliferation Ki-67 and Cell Cycle Dependent Protein kinase Inhibitor P16(INK4a) in Cervical Biopsy to Determine Its Biological Behaviour

OBJECTIVE: The aim of the study is to analyse the Immuno-histochemical expression of Ki-67 and P16(INK4a) in CIN and cervical cancer cases and their utility to determine the accuracy of histological diagnosis and prediction of biological behavior of cervical lesion. METHODOLOGY: A retrospective cross-sectional study was carried in 110 numbers of cervical biopsy that included 25 CIN1, 21 CIN2, 12 CIN3, 26 SCC and 01 adenocarcinoma and 25 non neoplastic lesion. The tissue sections were stained with Ki-67 and P16(INK4a). RESULTS: Ki-67 expression was seen in 55.5% (61/110) cases of cervical lesion., out of which 3.6% (4/110; cervicitis -2/110 and metaplasia-2/110) cases were non dysplaia, 51.8% (57/110) cases were dysplasia /CIN of varying grade including invasive cancer. P16(INK4a) expression was noted 51.8% (57/110). There was an increasing trend of the intensity of Ki-67 and P16(INK4a) from focal positivity in low grade lesion to diffuse intensity in higher grade lesion and is statistically significant. There was strong association between the two variables Ki-67 and P16(INK4a) positive cases with their histologic grade. CONCLUSION: Though histopathology remains the ‘‘gold standard’’ for the diagnosis of CIN, both low and high-grade, biomarkers like Ki-67 and P16(INK4a )have emerged as helpful adjuncts. Their combined use may assist in the histopathologic classification of preinvasive lesions and facilitate the distinction from nondysplasia.