Journal of Cytology
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Year : 2019  |  Volume : 36  |  Issue : 3  |  Page : 152-156

Evaluation of p16/Ki-67 dual staining compared with HPV genotyping in anal cytology with diagnosis of ASC-US for detection of high-grade anal intraepithelial lesions

1 Hospices Civils de Lyon, Virology Department, Institut des Agents Infectieux, Centre de Biologie et de Pathologie Nord, Hôpital de la Croix Rousse, Lyon, France
2 Hospices Civils de Lyon, Pathology Department, Centre de Biologie et de Pathologie Sud, Pierre Bénite, France
3 Hospices Civils de Lyon, Reproduction Department, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France

Correspondence Address:
Mojgan Devouassoux-Shisheboran
Service d'Anatomie Pathologique- Centre de Biologie et de Pathologie Sud, Chemin du Grand Revoyet - 69495 Pierre Bénite Cedex
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JOC.JOC_131_18

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Introduction: Human Papillomavirus (HPV) infection is the main risk factor for anogenital cancer. The objective of this study was to compare p16/Ki-67 dual staining to HPV genotyping in anal cytology samples with an atypical squamous cell of undetermined significance (ASC-US) for the identification of high-grade squamous intraepithelial lesion (HSIL). Methods: Anal cytology samples with an ASC-US result (n = 111) were collected from patients of a university hospital (Lyon, France) from 2014 to 2015. Cases with remaining squamous cells (n = 82) were stained using p16/Ki-67 dual staining (CINtec-Plus kit) and analyzed for HPV screening (CLART2-PCR kit) using a composite endpoint of biopsy and cytology results on follow-up specimens. Results: Detection of HSIL on follow-up specimens (5/22 biopsies; 1/29 cytology samples) was obtained in two out of six cases with p16/Ki-17 versus. five out of six with HPV genotyping alone. Sensitivity and specificity to detect HSIL for p16/Ki-67 was 33% (95% confidence interval [CI] [4; 77]) and 49% (95%CI [34; 64]) versus. 83% (95%CI [36; 99.6]) and 13% (95%CI [5; 27]) for HPV genotyping. Conclusion: Herein, HPV genotyping was more sensitive but less specific than p16/Ki-67 staining for the detection of subsequent HSIL in ASC-US anal cytology. A larger study is required to evaluate the combination of these biomarkers for triage.

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