A Study Of KI-67 And P16/INK4A Expression In Cervicalintraepithelial Neoplasia And Carcinoma And Its Histopathological Correlation

Abstract

Introduction: Cervical cancer remains a major health concern worldwide, and early detection of cervical intraepithelial neoplasia (CIN) is crucial for effective management. Ki-67 and p16/INK4a are established immunohistochemical markers indicating cellular proliferation and high-risk HPV-mediated oncogenic transformation.

Objective: This study aimed to evaluate Ki-67 and p16/INK4a expression in cervical lesions and correlate findings with histopathological grading.

Methods: A cross-sectional study was conducted on 107 cervical tissue specimens, including 88 cases of carcinoma cervix and 19 cases of squamous intraepithelial lesions (SIL). Histopathological evaluation was performed using H&E staining. Immunohistochemical analysis for Ki-67 and p16/INK4a was carried out on representative sections. Ki-67 expression was assessed according to the percentage of positive nuclei, while p16/INK4a expression was graded based on nuclear and cytoplasmic “block” staining patterns. Staining intensity and distribution were recorded and correlated with histopathological grade.

Results: Ki-67 and p16/INK4a expression increased progressively with lesion severity. High-grade SIL and invasive carcinoma showed strong and diffuse expression, whereas low-grade lesions and reactive epithelium demonstrated weak or focal staining. Combined positivity was predominantly observed in high-grade lesions. Histopathologically, the majority of carcinoma cases were squamous cell carcinoma, with well-differentiated tumors being most common. Clinically, irregular bleeding was the most frequent presenting complaint, followed by white vaginal discharge and lower abdominal pain.

Conclusion: Ki-67 and p16/INK4a are reliable adjuncts to histopathology for cervical lesion assessment. Their expression correlates with lesion grade, aiding in distinguishing low- from high-grade lesions and guiding management. Combined evaluation enhances diagnostic accuracy, facilitating early detection and timely intervention in cervical neoplasia.