Am J Obst Gynecol 2004; 190:668

John O. Schorge, Jayanthi S. Lea, Keren J. Elias, Ramababu Rajanbabu, Robert L. Coleman, David S. Miller, Raheela Ashfaq


OBJECTIVE:
Cervical adenocarcinomas are increasing in incidence each year. The aim of this study was to identify a molecular biomarker to improve early detection.

STUDY DESIGN:
Fifty-five in situ and invasive cervical adenocarcinomas were compared with 5 normal endocervical controls by immunohistochemical analysis of p16, p21, p27, cyclin D1, cyclin E, p53, and Ki-67. Expression was scored from 0 to 8 by using an automated imaging system. Western blotting and polymerase chain reaction-based human papillomavirus (HPV) testing were performed on 16 of the invasive cases having fresh-frozen tissue.

RESULTS:
P16 exhibited a higher mean expression score for in situ (7.4; P!.0001) and invasive cervical adenocarcinoma (6.6; P!.0001) versus controls (2.0). A cutoff p16 expression score of 5 had a sensitivity of 94.5% and a specificity of 100%. Western blotting confirmed p16 protein expression. Fourteen (88%) of 16 invasive cervical adenocarcinomas were HPV-positive.

CONCLUSION:
P16 is a putative molecular biomarker of cervical adenocarcinoma. Overexpression appears to primarily reflect HPV-induced cell cycle dysregulation.