Investigation of the P16 and Ki67 Predictive Effect on the Progression of Cervical Intraepithelial Neoplasia Grade 1 in Shahid Motahari Hospital of Urmia, Iran

Background & Objective: Cervical cancer is a common neoplasm in women, and the role of the HPV virus in the development of precancerous and cancerous cells has been established. There exist different strains of the HPV virus with varied functions. In the high-risk HPV strains, the p16 and ki67 proteins play a crucial role in regulating the cell cycle leading to cell proliferation and progression. P16 and ki67 proteins are positive in almost all lesions and indicate a high degree of malignancy. This study aims to investigate the predictive effect of p16 and ki67 on the progression of low-grade intraepithelial lesions to high-grade malignancy. Materials & Methods: P16 and ki67 were measured on CIN1 lesions, and during the average two-year follow-up period, the outcome of positive cases was investigated. A total of 106 referred patients between the age of 15 to 75 years were examined from April 2015 to March 2019. Results: Among the patients with progression of CIN1 to CIN2 and other severe lesions, p16 was positive in 14 cases (60.9%), and a significant difference between groups with positive and negative markers in the progression or regression of lesions was noticed. Ki67 frequently occurs in CIN2 and other severe lesions. Conclusion: The use of p16 and ki67 as predictive markers is still under debate. In countries like the United States, these are not yet used separately for prediction but are being used in combination together. The authors of this study strongly recommend the conduction of further studies to assess the role of p16 in association with other markers and within a larger population so as to apply the functional role of p16 and ki67 in the clinical setting thereby effectively preventing it.