Argentophilic nucleolus organizer region as a proliferation marker in cervical intraepithelial neoplasia grade 1 of the uterine cervix.

GUERRA F, ROCHER AE, VILLACORTA HIDALGO J, DíAZ L, VIGHI S, CARDINAL L, TATTI S, CúNEO N, PRAT GAY G, CAMPOREALE G, PALAORO LA

J Obstet Gynaecol Res

John Wiley & Sons, Inc

Año: 2014 vol. 40 p. 1717 - 1724

1447-0756

Abstract Aims: p16INK4a and AgNOR can be used as markers for progression of cervical intraepithelial neoplasia grade 1(CIN1s) of the uterine cervix. The objective was to study the predictive value of the AgNOR technique as a progression marker of CIN1s and its relationship with p16INK4A. Methods: One uterine cervix biopsy from each of 75 patients with diagnosis of CIN 1 was selected. All these patients had a second biopsy performed, and these were also used for the study. Results:The second biopsies showed: regression (20 patients), persistent CIN 1 (38 patients), progression to CIN 2 (10 patients) and progression to CIN 3 (7 patients). p16INK4A showed reactivity in 67 of the 75 first CIN1 biopsies: 12 of the 20 cases that cleared the lesions and the 55 cases with persistent or progressive lesions were positive for p16INK4a. (Specificity:40%; Sensitivity:100%; Positive predictive value (PPV): 82%; Negative predictive value (NPV): 100%) Samples with AgNOR areas less  than 3.0 ì2 returned in all cases, but patients whose lesions persisted or progressed to CIN2/CIN3, showed AgNOR areas greater than 3.0 ì2 in 50/55 cases (Specificity: 100% ; Sensitivity: 91%; PPV: 100%; NPV: 80%) Conclusions: p16INK4a is expressed in a high percentage of returning lesions. AgNOR might be a better marker of proliferation of CIN1 than p16INK4a (PPV = 100%), which means that a value greater than 3.0 ì2 indicates the persistence or progression of the lesion. As its NPV is 80%, a value of AgNOR area less than  3,0 ì2 in CIN1 leaves a margin of doubt about to the future behavior of the lesion.