Relationships of p16 Immunohistochemistry and Other Biomarkers With Diagnoses of Cervical Abnormalities: Implications for LAST Terminology

Authors

• Philip E. Castle, Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
• Rachael Adcock, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
• Jack Cuzick, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
• Nicolas Wentzensen, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
• Norah E. Torrez-Martinez, Department of Pathology, University of New Mexico Cancer Center, Albuquerque
• Salina M. Torres, Department of Pathology, University of New Mexico Cancer Center, Albuquerque
• Mark H. Stoler, Department of Pathology, University of Virginia Health System, Charlottesville
• Brigitte M. Ronnett, Department of Pathology, Johns Hopkins University, Baltimore, Maryland
• Nancy E. Joste, Department of Pathology, University of New Mexico Cancer Center, Albuquerque
• Teresa M. Darragh, Department of Pathology, University of California, San Francisco
• Patti E. Gravitt, Department of Pathology, University of New Mexico Cancer Center, Albuquerque
• Mark Schiffman, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
• William C. Hunt, Department of Pathology, University of New Mexico Cancer Center, Albuquerque
• Walter K. Kinney, University of California Sacramento, California
• Cosette M. Wheeler, Department of Pathology, University of New Mexico Cancer Center, Albuquerque

Document Type

Article

Publication Date

6-1-2020

Abstract

CONTEXT.—: Lower Anogenital Squamous Terminology (LAST) standardization recommended p16

OBJECTIVE.—: To describe the relationships of p16 IHC and other biomarkers associated with cervical cancer risk with biopsy diagnoses.

DESIGN.—: A statewide, stratified sample of cervical biopsies diagnosed by community pathologists (CPs), including 1512 CIN2, underwent a consensus, expert pathologist panel (EP) review (without p16 IHC results), p16 IHC interpretation by a third pathology group, and human papillomavirus (HPV) genotyping, results of which were grouped hierarchically according to cancer risk. Antecedent cytologic interpretations were also available.

RESULTS.—: Biopsies were more likely to test p16 IHC positive with increasing severity of CP diagnoses, overall (

CONCLUSIONS.—: p16 IHC-positive, CP-diagnosed CIN2 appears to be lower cancer risk than CP-diagnosed CIN3. LAST classification of "HSIL" diagnosis, which includes p16 IHC-positive CIN2, should annotate the morphologic diagnosis (CIN2 or CIN3) to inform all management decisions, which is especially important for young (years) women diagnosed with CIN2 for whom surveillance rather than treatment is recommended.

Recommended Citation

Castle PE, Adcock R, Cuzick J, Wentzensen N, Torrez-Martinez NE, Torres SM, Stoler MH, Ronnett BM, Joste NE, Darragh TM, Gravitt PE, Schiffman M, Hunt WC, Kinney WK, Wheeler CM; New Mexico HPV Pap Registry Steering Committee; p16 IHC Study Panel. Relationships of p16 Immunohistochemistry and Other Biomarkers With Diagnoses of Cervical Abnormalities: Implications for LAST Terminology. Arch Pathol Lab Med. 2020 Jun;144(6):725-734. doi: 10.5858/arpa.2019-0241-OA. Epub 2019 Nov 13. PMID: 31718233; PMCID: PMC8575174.