Clinical value of p16 and geminin in the progress of patients with low-grade squamous intraepithelial lesions

Abstract

Objective To analyze the positive expression levels of p16 (p16ink4a), cell cycle factor geminin and Ki-67 in low-grade squamous intraepithelial lesions (LSIL), and to further explore the ability of these indicators to evaluate the progression of LSIL patients. Methods From January 2015 to June 2018, 276 cervical specimens from Jiading District Central Hospital of Shanghai were retrospectively studied, and 148 LSIL patients were selected.According to the results of the second examination, LSIL patients were divided into three groups: (1) no lesion (natural regression) group 90 cases; (2) LSIL persistent group 38 cases; (3) high-grade Squamous Intraepithelial Lesion (HSIL) group 20 cases.Immunohistochemistry was performed on the first biopsy tissues and the relative positive ratios of p16, geminin and Ki-67 were calculated.Spearman correlation analysis identified the correlation between the above indicators and the progress of the disease; ROC curve was used to calculate the best diagnostic value of each indicator, and multivariate logistic regression analysis was included to explore the ability of the above indicators to assess the risk of patients progressing to HSIL. Results In the HSIL group, p16 (51.26±17.15)%, geminin relative positive ratio (45.92±15.70) % was higher than those in the LSIL group((43.71±11.84)%, (21.68±14.47)%) and regression group((17.92±9.60)%, (0.16±0.03)%). The difference were statistically significant (F=2.922, 2.751, all P<0.05). Spearman correlation analysis showed that the relative positive ratio of p16 (r=0.27, P=0.014) and geminin (r=0.44, P<0.001) presented a notable positive correlation with the progression of the disease.Under the ROC curve, the best diagnostic values of p16, geminin and Ki-67 were 38.9%, 32.5% and 18.6%, respectively.Multivariate logistic regression analysis showed that the relative positive ratio of p16 was higher than 38.9% (OR=4.366, P=0.006), and geminin was higher than 32.5% (OR=5.392, P=0.011) had a higher risk of progression to HSIL. Conclusion p16 and geminin may be effective biomarkers for identifying patients with advanced LSIL. Key words: p16; Cell cycle factor geminin; Ki-67; Low-grade squamous intraepithelial lesions; High-grade squamous intraepithelial lesions