Original Research Article
Year: 2019 | Month: July | Volume: 6 | Issue: 7 | Pages: 400-407
Role of Proliferative Markers in the Differential Diagnosis of Cervical Cytology
Dr. Iftekhar Jalil Baig1, Dr. Sucharita Sarkar2, Dr. Asim Kumar Manna3, Dr. Saswati Sengupta4, Dr. Mousumi Bag5
1Consultant Pathologist, Bellevue Clinic, Kolkata, West Bengal
2Demonstrator, R.G Kar Medical College & Hospital, Kolkata - 700004, West Bengal.
3Professor, Institute of Post Graduate Medical Education and Research, Kolkata-700 020, West Bengal
4Post graduate trainee, Dept of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata-700 020, West Bengal
Corresponding Author: Dr. Sucharita Sarkar
ABSTRACT
Cervical squamous intraepithelial lesions are premalignant lesions which are capable of progressing to invasive cervical cancer. Despite the advent of liquid based cytology and totally computerised analysis sand screening system, the diagnosis in cervical cytology is still subjected to high rates of discordance due to sampling errors, inter- and intra-observer variability as well as poor reproducibility.The objective of the study is to assess the role of proliferative markers i.e Ki67 and PCNA in diagnosis of cervical squamous intraepithelial lesions.
Methodology- Out of this total 1006, 77 cervical smears were diagnosed as squamous intraepithelial lesions. All these were subjected to immunostaining by Ki67 and PCNA,14 smears with diagnosis of NILM were also immunostained as control. The results showed clustering of labeling index of Ki67 and PCNA, ascending from NILM to ASCUS, ASCUS-H, LSIL, HSIL and finally carcinoma cervix.Ki67 and PCNA index were studied in all the immunostained slides and calculated to the nearest percent. Statistical analysis was done by student t test.
Result- In ascending order, comparison was done between NILM with ASCUS, ASCUS with LSIL, LSIL with ASC-H,ASC-H with HSIL and finally HSIL with CaCx, in both Ki67 and PCNA groups. p values were found significant in all the groups except between LSIL vs ASC-H.
Conclusion-The study showed stratification of lesions ascending from NILM,ASCUS, ASC-H, LSIL, HSIL, CaCx ,in terms of Ki67 and PCNA labelling index. The study proved that these proliferative markers could be utilised as an adjunct to routine cervical smears analysis.
Key words: Squamous intraepithelial lesions, cervical cancer, Proliferative markers, labeling index.
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