Three-tiered score for Ki-67 and p16ink4a improves accuracy and reproducibility of grading CIN lesions

Journal of Clinical Pathology
Marjolein van ZummerenChris J L M Meijer

Abstract

To investigate the accuracy and reproducibility of a scoring system for cervical intraepithelial neoplasia (CIN1-3) based on immunohistochemical (IHC) biomarkers Ki-67 and p16ink4a. 115 cervical tissue specimens were reviewed by three expert gynaecopathologists and graded according to three strategies: (1) CIN grade based on H&E staining only; (2) immunoscore based on the cumulative score of Ki-67 and p16ink4a only (0-6); and (3) CIN grade based on H&E supported by non-objectified IHC 2 weeks after scoring 1 and 2. The majority consensus diagnosis of the CIN grade based on H&E supported by IHC was used as the Reference Standard. The proportion of test positives (accuracy) and the absolute agreements across pathologists (reproducibility) of the three grading strategies within each Reference Standard category were calculated. We found that immunoscoring with positivity definition 6 yielded the highest proportion of test positives for Reference Standard CIN3 (95.5%), in combination with the lowest proportion of test positives in samples with CIN1 (1.8%). The proportion of test positives for CIN3 was significantly lower for sole H&E staining (81.8%) or combined H&E and IHC grading (84.8%) with positivity definition ≥CIN3. Immunosco...Continue Reading

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Citations

Aug 24, 2018·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Marjolein van ZummerenChris J L M Meijer
Sep 6, 2019·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Heather GriffinJohn Doorbar
Nov 14, 2019·Archives of Pathology & Laboratory Medicine·Philip E CastleUNKNOWN p16 IHC Study Panel
Apr 7, 2020·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Wieke W KremerChris J L M Meijer
Mar 25, 2020·International Journal of Molecular Sciences·Saioa MendazaEsperanza Martín-Sánchez
Oct 13, 2020·Expert Review of Molecular Diagnostics·Mariano A MolinaKarolina M Andralojc
Jul 27, 2021·International Journal of Cancer. Journal International Du Cancer·Ramon P van der ZeeRenske D M Steenbergen

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Methods Mentioned

BETA
biopsy

Software Mentioned

STATA
SPSS

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