Predictive value of Ki-67 and p16 protein expression in pregnant women infected with HPV for assessing the course of intraepital lesions of cervix
The purpose - to determine the expression of Ki-67 and p16 in pregnant women infected with HPV, and their role in the diagnosis and prognosis of severe cervical neoplasia. Material and methods. Design: open-label observational non-interventional cohort clinical study. We examined 26 pregnant women infected with HPV, aged 23 to 31 years. Methods: general clinical nethods, Kvant-21 test for determining HPV types and quantitative load, cytological examination, determination of the expression of Ki-67 and p16 proteins by immunocytochemical method. Results. It was shown that with an increase of the cervical lesion severity, the proportion of patients with tumor markers increased (from 20% with NILM to 100% with HSIL), and the intensity of Ki-67/p16 expression was moderate (2+) in 25% of patients with LSIL and high (3+) in 100% of patients with HSIL. A higher statistically significant viral load was detected for the HPV A9 DNA group (16, 31, 33, 35, 52, 58 types) upon detection of tumor markers compared with their absence, confirmed by a logit regression model with a sensitivity of 100% and a specificity of 89%. Conclusion. Due to the lack of an unambiguous opinion about the extent to which changes in the expression of Ki-67 and p16 reflect information about the CIN evolution during pregnancy, further research is needed to obtain data that would allow for an appropriate interpretation of the revealed phenomena.