IMMUNOHISTOCHEMICAL EXPRESSION OF P16INK4a IN INFLAMMATORY, PRENEOPLASTIC AND NEOPLASTIC CERVICAL LESIONS.

INTRODUCTION High-risk human papilloma viruses play a main role in the development of cervical dysplasias and carcinomas. p16INK4a can be considered as a surrogate marker of active high-risk human papillomaviruses infection in dysplastic and neoplastic cells of the cervix. This study was aimed at determining the presence and level of pl6INK4a expression in inflammatory, preneoplastic and neoplastic lesions of the cervix. MATERIAL AND METHODS The study was performed on 109 samples of cervical biopsy. Cervical cancer was diagnosed in 36 patients, 34 patients had a preneoplastic change (dysplasia) in stratified squamous cervix epithelium and a nonspecific inflammatory process was found in 39 patients. In all samples, immunohistochemical analysis using antibodies to pl6INK4a was performed. RESULTS The expression of pl6INK4a was verified in all cases of cervical cancer (100%), in 67.65% of dysplastic cervical lesions and in 38.5% of inflammatory lesions. A statistically highly significant difference was found in the presence and level of expression among neoplasic, dysplastic and inflammatory lesions of the cervix (χ2 = 76.02, p <0.001). The expression was more frequent and had a higher level in neoplastic and high grade dysplastic lesions compared to expression in inflammatory lesions and low grade dysplasias. CONCLUSION The analysis of the presence of pl6INK4a can differentiate non-neoplastic, high grade preneoplastic and neoplastic changes of the cervix. The use of pl6INK4a in interpreting borderline lesions of the cervix can enable a rational theraDeutic treatment of patients.