Zin, Anani Aila Mat
(2019)
Evaluating the p53 as diagnostic marker by using liquid based
cervical sample in cervical carcinogenesis.
The 59th IAP Thailand annual meeting.
(Submitted)
Abstract
Background:
p53 is known as the guardian genome and tumour suppressor gene as it involved in the induction of cell cycles
and preventing mutation by activating cellular apoptosis. P53 mutation is observed in numerous types of
malignancies such as in ovary, lungs, breast, colorectal , uterus and cervical cancer. Cervical cancer is one of the
most common cancer in the female population. According to the Malaysian National Cancer Registry 2007-2011,
the prevalence of cervical cancer among other female cancer in Malaysia was observed at 7.7%. The association
between the Human Papillomavirus (HPV) infection and cervical cancer is well established. The emergence of the
HPV negative squamous lesion could hamper the high-risk HPV (hrHPV) detection in Pap smear. Instead of
looking into the HPV protein, we explored the expression of p53 in various stages of cervical carcinogenesis and
determine the utility of p53 as potential diagnostic marker for cervical cancer.
Materials and Methods:
This is a cross-sectional study using left over samples of routine liquid based cytology (LBP) from Ministry of Health
facilities in Johor Bahru, Johor and Kota Bharu. Kelantan from May 2016 to May 2018. All the LBP samples were
selected according to cervical carcinogenesis; negative for intraepithelial malignancy (NILM), low grade squamous
intraepitheliallesion (LSIL}, high grade squamous intraepitheliallesion (HSIL} and squamous cell carcinoma (SCC)
and fulfilled the inclusion and exclusion criterion. Each LBP smear underwent cytopathological examination by
respective resident pathologists and certified medical laboratory technicians, results were classified according The
Bethesda System (TBS) 2014. The selected left over samples were converted to cell blocks and were subjected
for p53 IHC staining. The nuclear expression of p53 IHC stain was assessed and quantified by usingHisto-score
(H-Score). The cytological diagnosis was not known during the interpretation of the IHC
Result:
The p53 IHC scores obtained showed an increase in p53 expression in more severe cervical dysplasia and SCC
and showed good sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The
statistical analysis between the mean p53 IHC score with cervical carcinogenesis categories were done using
analysis of variance (ANOVA) which showed statistically significant result, p value <0.05. Post-hoc test (Tukey)
among the cervical carcinogenesis categories showed statistically significant results, p value <0.05.
Conclusion:
Our findings suggest that p53 can be used as a diagnostic tool to differentiate normal cervical pap smear samples
from the sample that has undergone different stages of cervical carcinogenesis. p53 also manage to stratify each
category of cervical carcinogenesis. The cell blocks are also providing an excellent ancillary test for routine cervical
pap smears.
Actions (login required)
 |
View Item |
