Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Diagnostic Value of Protein Ki67 (MIB-1) in Atypical Pap Smears of Postmenopausal Women

  • Published : 2013.08.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Atrophic epithelium of cervix sampled from postmenopausal women may mimic high-grade cervical intraepithelial neoplasia in Papanicolaou-stained (Pap) smears. Ki-67 (MIB-1) protein presents on proliferating cells, and percentage of cells with positive nuclei provides a reliable tool for rapid evaluation of the growth fraction. The aim of this study was to determine the diagnostic value of protein Ki67 staining in atypical pap smears of postmenopausal women. Methods: In a case-control setting, pap smears of 75 women with an atypical pap smear (case group) and 75 with normal pap smears (controls) were obtained before and after estrogen treatment. Afterward, samples were exposed to the monoclonal antibody Ki-67 (MIB-1) and the immunohistochemically demonstrated Ki-67+ cells were compared. Results: Mean ages of cases and controls were $60.4{\pm}4.5$ and $59.9{\pm}4.3$ years respectively (P=0.50). There was one (2.7%) positive Ki-67 specimen in the case group, without any positive Ki-67 specimen in the control group (P=0.50). Conclusions: Measurement of proliferative activity index in Pap smears restrained with MIB1 is a simple, reliable, and cost-effective method for excluding negatives. This would imply that it might allow a substantial reduction of diagnostic estrogen courses and subsequent Pap smears in postmenopausal women with atypical findings.

Keywords

References

  1. Amirnia M, Babaie-Ghazani A, Fakhrju A, et al (2012). Immunohistochemical study of cyclooxygenase-2 in skin tumors. J Dermatolog Treat, [Epub ahead of print].
  2. Atkins K (2011). p16/Ki-67 dual-stain cytology in the triage of ASCUS and LSIL Papanicolaou cytology. Cancer Cytopathology, 119, 145-7. https://doi.org/10.1002/cncy.20139
  3. Baghiani Moghadam M (2003). Survey on knowledge, attitude and practice of 15-49 years age group married women related to Pap smear test in Yazd city in 2001. J Mazandaran University of Medical Sciences, 13, 79-85.
  4. Boon ME, Vinkestein A, van Binsbergen-Ingelse A, van Haaften C (2004). Significance of MiB-1 staining in smears with atypical glandular cells. Diagnostic Cytopathology, 31, 77-82. https://doi.org/10.1002/dc.20043
  5. BBosch FX, Lorincz A, Munoz N, et al (2002). The causal relation between human papillomavirus and cervical cancer. J Clin Pathol, 55, 244-65. https://doi.org/10.1136/jcp.55.4.244
  6. Brown D, Gatter K (2002). Ki67 protein: the immaculate deception? Histopathology, 40, 2-11. https://doi.org/10.1046/j.1365-2559.2002.01343.x
  7. Bulten J, de Wilde PC, Boonstra H, Gemmink JH, Hanselaar AG (2000). Proliferation in "atypical" atrophic Pap smears. Gynecol Oncol, 79, 225-9. https://doi.org/10.1006/gyno.2000.5943
  8. Bulten JP, de Wilde P, Boonstra H, et al (2000). Decreased expression of Ki-67 in atrophic cervical epithelium of post-menopausal women. J Pathol, 190, 545-53. https://doi.org/10.1002/(SICI)1096-9896(200004)190:5<545::AID-PATH549>3.0.CO;2-S
  9. Davey DD, Zarbo RJ (2003). Introduction and commentary, Strategic Science Symposium: human papillomavirus testing-are you ready for a new era in cervical cancer screening? Arch Pathol Lab Med, 127, 927-9.
  10. Do H, Seng P, Talbot J, et al (2009). HPV vaccine knowledge and beliefs among Cambodian American parents and community leaders. Asian Pac J Cancer Prev, 10, 339-44.
  11. Ejersbo D, Jensen H, Holund B, et al (1999). Efficacy of Ki-67 antigen staining in Papanicolaou (Pap) smears in pos-menopausal women with atypia-an audit. Cytopathology, 10, 369-74. https://doi.org/10.1046/j.1365-2303.1999.00205.x
  12. Gertych A, Joseph AO, Walts AE, et al (2012). Automated detection of dual p16/Ki67 nuclear immunoreactivity in liquid-based pap tests for improved cervical cancer risk stratification. Annals of Biomedical Engineering, 40, 1192-204. https://doi.org/10.1007/s10439-011-0498-8
  13. Ghojazadeh M, Azar ZF, Saleh P, et al (2012). Knowledge and attitude of iranian university students toward human papilloma virus. Asian Pac J Cancer Prev, 13, 6115-9. https://doi.org/10.7314/APJCP.2012.13.12.6115
  14. Ghojazadeh M, Naghavi-Behzad M, Azar ZF, et al (2012). Parental knowledge and attitudes about human papilloma virus in Iran. Asian Pac J Cancer Prev, 13, 6169-73. https://doi.org/10.7314/APJCP.2012.13.12.6169
  15. Ghojazadeh M, Mohammadi M, Azami-Aghdash S, et al (2013). Estimation of cancer cases using capture-recapture method in Northwest Iran. Asian Pac J Cancer Prev, 14, 3237-41. https://doi.org/10.7314/APJCP.2013.14.5.3237
  16. Gibbs RS, Danforth DN (2008). Danforth's obstetrics and gynecology, Lippincott Williams & Wilkins.
  17. Goel M, Mehrotra A, Singh U, et al (2005). MIB-1 and PCNA immunostaining as a diagnostic adjunct to cervical pap smear. Diagnostic Cytopathology, 33, 15-9. https://doi.org/10.1002/dc.20218
  18. Gupta N, Rajwanshi A (2013). Gynecological cancers: pathology and cytological methods for diagnosis of gynecological cancers. In 'Breast and Gynecological Cancers'
  19. Hanprasertpong J, Tungsinmunkong K, Chichareon S, et al (2010). Correlation of p53 and Ki-67 (MIB-1) expressions with clinicopathological features and prognosis of early stage cervical squamous cell carcinomas. J Obstet Gynaecol Res, 36, 572-80. https://doi.org/10.1111/j.1447-0756.2010.01227.x
  20. Jackson JA, Kapur U, Ersahin C, et al (2012). Utility of p16, Ki-67, and HPV test in diagnosis of cervical intraepithelial neoplasia and atrophy in women older than 50 years with 3-to 7-year follow-up. Int J Surg Pathol, 20, 144-51. https://doi.org/10.1177/1066896911427703
  21. Keating JT, Cviko A, Riethdorf S, et al (2001). Ki-67, cyclin E, and p16 INK4 are complimentary surrogate biomarkers for human papilloma virus-related cervical neoplasia. Am J Surg Pathol, 25, 884-91. https://doi.org/10.1097/00000478-200107000-00006
  22. Mimica M, Tomic S, Kardum G, et al (2010). Ki-67 quantitative evaluation as a marker of cervical intraepithelial neoplasia and human papillomavirus infection. Int J Gynecol Cancer, 20, 116-9. https://doi.org/10.1111/IGC.0b013e3181bc8da7
  23. Moore MA, Tajima K (2004). Cervical cancer in the Asian Pacific-epidemiology, screening and treatment. Asian Pac J Cancer Prev, 5, 349-61.
  24. Munoz N, Bosch FX, de Samjose S, et al (2003). Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med, 348, 518-27. https://doi.org/10.1056/NEJMoa021641
  25. Pahuja S, Choudhury M, Gupta U, et al (2004). Ki-67 immunostaining in Pap smears of cervix: assessment of proliferation in preinvasive and invasive squamous epithelial lesions. Indian J Pathol Microbiol, 47, 1-3.
  26. Petry KU, Schmidt D, Scherbring S, et al (2011). Triaging pap cytology negative, HPV positive cervical cancer screening results with p16/Ki-67 dual-stained cytology. Gynecol Oncol, 121, 505-9. https://doi.org/10.1016/j.ygyno.2011.02.033
  27. Qiao X, Bhuiya TA, Spitzer M, et al (2005). Differentiating high-grade cervical intraepithelial lesion from atrophy in postmenopausal women using Ki-67, cyclin E, and p16 immunohistochemical analysis. J Low Genit Tract Dis, 9, 100-7. https://doi.org/10.1097/00128360-200504000-00006
  28. Samir R, Asplund A, Tot T, et al (2011). High-risk HPV infection and CIN grade correlates to the expression of c-myc, CD4+, FHIT, E-cadherin, Ki-67, and p16INK4a. J Low Genit Tract Dis, 15, 280-6. https://doi.org/10.1097/LGT.0b013e318215170c
  29. Siemens FC, van Haaften C, van Haaften C, et al (2011). Progression of abnormal MIB-1 staining patterns of reserve cells in cervical smears from women ultimately developing high grade squamous intraepithelial lesions. Acta Cytol 50, 637-42.
  30. Smedts F (2001). Efficacy of Ki-67 antigen staining in Papanicolaou (pap) smears in postmenopausal women with atypia-an audit. Cytopathology, 12, 130-2. https://doi.org/10.1046/j.1365-2303.2001.0293c.x
  31. Son SM, Noh KI, Lee HC, et al (2012). Evaluation of p16INk4a, pRb, p53 and Ki-67 expression in cervical squamous neoplasia. Cell Cycle, 5, 6.
  32. Vu LT, Bui D (2012). Prevalence of cervical human papilloma virus infection among married women in Vietnam, 2011. Asian Pac J Cancer Prev, 13, 37-40. https://doi.org/10.7314/APJCP.2012.13.1.037
  33. Wong F (2010). Immunohistochemical detection of proliferating tumor cells in cervical cancer using monoclonal antibody Ki-67. Gynecol Obstet Inves, 37, 123-6.
  34. Zhang HY, Tiggelaar SM, Sahasrabuddhe VV, et al (2012). HPV prevalence and cervical intraepithelial neoplasia among HIV-infected women in Yunnan Province, China: a pilot study. Asian Pac J Cancer Prev, 13, 91-6. https://doi.org/10.7314/APJCP.2012.13.1.091

Cited by

  1. Knowledge Production Status of Iranian Researchers in the Gastric Cancer Area: Based on the Medline Database vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.5083
  2. Ki-67/MIB-1 as a Prognostic Marker in Cervical Cancer - a Systematic Review with Meta-Analysis vol.16, pp.16, 2015, https://doi.org/10.7314/APJCP.2015.16.16.6997
  3. Ki-67 is a Valuable Prognostic Factor in Gliomas: Evidence from a Systematic Review and Meta-analysis vol.16, pp.2, 2015, https://doi.org/10.7314/APJCP.2015.16.2.411
  4. Comparative Study of Dermatoscopic and Histopathologic Results in Facial Basal Cell Carcinoma and Melanocytic Nevi vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.425