Expressão imunohistoquímica de CK7 e p16 em epitélio escamoso normal e neoplasias intraepiteliais cervicais e o desfecho clínico de pacientes com NIC de graus 1 e 2

• Ano de defesa: 2018
• Autor(a) principal: Lima, Tatiana Megale de [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: CK7; P16; Nic; HPV
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6497052; https://repositorio.unifesp.br/handle/11600/52662

Persistent cervical infection cause by highrisk HPV is necessary for development of precursor lesions and tumor progression. Early diagnosis is a determining factor that assists in the treatment of the disease avoiding the progression or development of lesions. LAST consensus determines the use of immunohistochemistry of p16 protein as an adjunct to morphologic assessment of biopsies. The p16 has achieved a major role in the classification of CIN 2/3 lesions, but in CIN 1 vary greatly. Objective: Considered these facts and seeking to find new biomarkers to improve the diagnostic of lesions this immunohistochemical study aimed to evaluate the p16 and CK7 expression profile in different degrees of cervical squamous intraepithelial neoplasia (CIN), and nonneoplastic cervical tissue. Methods: Formalinfixed paraffinembedded tissue samples included 100 cervical biopsies of precursor lesions distributed into CIN 1, CIN 2, CIN 3 groups and 47 samples in the nonneoplastic group. Immunohistochemistry assay was performed in tissue microarray and the 4 μm tissue section with antibody clone G175405 for p16 at a dilution of 1:50 and the prediluted FLEX antibody clone OVTL 12/30 for CK7. Quantitative variables and clinical outcome were analyzed by KruskalWallis and Chisquare or exact Fisher tests, respectively ( < 0.05). CIN 1 and CIN 2 groups’ clinical followup exhibited that the most patients had a favorable outcome. Results: CIN 1 group showed the p16 or CK7 isolate immunoexpression had a greater sensitivity and negative predictive value as well as relevant specificity estimate. p16 positive predictive value was greater than CK7. Combined expression profile of p16 and CK7 exhibited that the sensitivity, specificity and positive and negative predictive values had the maximum index in the CIN 1 group. Combined expression of p16 and CK7 showed that 85.7% of patients presented unfavorable clinical outcome with the positive expression for both markers in CIN 2. Conslusion: CK7 and p16 combined immunoexpression showed a better diagnosis of cervical lesions and the negative expression in CIN 1 and CIN 2 groups had a greater negative predictive value for patients' clinical outcome.