COMPARATIVE EVALUATION OF P16, P53, AND KI-67 EXPRESSION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND INVASIVE CERVICAL CARCINOMA: A PROSPECTIVE HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY
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Abstract
Introduction: Cervical cancer remains a leading cause of cancer-related mortality among women worldwide, particularly in developing countries. Persistent infection with high-risk human papillomavirus types, mainly 16 and 18, plays a pivotal role in the transformation from cervical intraepithelial neoplasia to invasive squamous cell carcinoma. Immunohistochemical markers including p16, p53, and Ki-67 are valuable in improving diagnostic precision and grading disease severity.
Objective: This study aimed to evaluate and compare the expression patterns of p16, p53, and Ki-67 in precancerous and malignant cervical lesions and to correlate these markers with histopathological grades.
Methods: A prospective observational study was carried out over fifteen months in a tertiary care hospital in northern India, analyzing one hundred cervical biopsy samples. Each specimen underwent hematoxylin and eosin staining and immunohistochemical testing for p16, p53, and Ki-67. Marker expression was scored according to staining intensity and distribution, and statistical associations were examined using chi-square tests and correlation analysis.
Results: A significant progressive increase in p16, p53, and Ki-67 expression was observed with higher grades of cervical lesions (p < 0.0001 for all). Ki-67 positivity rose from 5 percent in low-grade lesions to 57 percent in severe dysplasia, reflecting enhanced proliferative activity. p53 expression increased from 10 percent in mild dysplasia to 65 percent in severe lesions, indicating progressive alteration of tumor suppressor pathways. p16 expression rose from 12 percent in early lesions to 59 percent in advanced grades, consistent with oncogenic human papillomavirus integration.
Conclusion: Immunohistochemical evaluation of p16, p53, and Ki-67 provides a reliable adjunct for diagnosis and grading of cervical precancer and cancer. Their combined use enhances accuracy, supports early identification of high-risk cases, and guides individualized clinical management for better patient outcomes.
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