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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Impact of utilizing p16
INK4A
immunohistochemistry on estimated performance of three cervical cancer screening tests
International Journal of Cancer, Volume 120, No. 2, Year 2007
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Description
The histopathological diagnosis of cervical intraepithelial neoplasia grade 2,3 (CIN 2,3) is subjective and prone to variability. In our study, we analyzed the impact of utilizing a biomarker (p16INK4A) together with histopathology to refine the "gold standard" utilized for evaluating the performance of 3 different cervical cancer screening tests: cervical cytology, human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Cervical biopsies from 2 South African cervical cancer screening studies originally diagnosed by a single pathologist were reevaluated by a second pathologist and a consensus pathology diagnosis obtained. Immunohistochemical staining for p16INK4A was then performed. The estimated sensitivity of some cervical cancer screening tests was markedly impacted by the criteria utilized to define CIN 2,3. Use of routine histopathology markedly underestimated the sensitivity of both conventional cytology and HPV DNA testing compared to an improved gold standard of consensus pathology and p16INK4A positivity. In contrast, routine histopathology overestimated the sensitivity of VIA. Our results demonstrate that refining the diagnosis of CIN 2,3 through the use of consensus pathology and immunohistochemical staining for p16INK4A has an important impact on measurement of the performance of cervical cancer screening tests. The sensitivity of screening tests such as HPV DNA testing and conventional cytology may be underestimated when an imperfect gold standard (routine histopathology) is used. In contrast, the sensitivity of other tests, such as VIA, may be overestimated with an imperfect gold standard. © 2006 Wiley-Liss, Inc.
Authors & Co-Authors
Zhang, Qi
United States, New York
Columbia University
Kuhn, Louise
United States, New York
Gertrude H. Sergievsky Center
Denny, Lynette A.
South Africa, Cape Town
University of Cape Town
de Souza, Michelle
South Africa, Cape Town
University of Cape Town
Taylor, Sylvia M.
United States, New York
Columbia University
Wright, Thomas C.
United States, New York
Columbia University
Statistics
Citations: 54
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1002/ijc.22172
ISSN:
00207136
e-ISSN:
10970215
Research Areas
Cancer
Genetics And Genomics