@article{3220472,
    title = "p16/Ki-67 Dual Staining Is a Reliable Biomarker for Risk Stratification for Patients with Borderline/Mild Cytology in Cervical Cancer Screening",
    author = "Magkana, M. and Mentzelopoulou, P. and Magkana, E. and Pampanos, A. and Vrachnis, N. and Kalafati, E. and Daskalakis, G. and Domali, E. and Thomakos, N. and Rodolakis, A. and Anagnou, N.P. and Pappa, K.I.",
    journal = "ANTICANCER RESEARCH",
    year = "2022",
    volume = "42",
    number = "5",
    pages = "2599-2606",
    publisher = "International Institute of Anticancer Research",
    issn = "0250-1291",
    doi = "10.21873/anticanres.15738",
    keywords = "cyclin dependent kinase inhibitor 2A;  Ki 67 antigen, early cancer diagnosis;  female;  human;  papillomavirus infection;  risk assessment;  staining;  uterine cervix carcinoma in situ;  uterine cervix tumor, Cervical Intraepithelial Neoplasia;  Cyclin-Dependent Kinase Inhibitor p16;  Early Detection of Cancer;  Female;  Humans;  Ki-67 Antigen;  Papillomavirus Infections;  Risk Assessment;  Staining and Labeling;  Uterine Cervical Neoplasms",
    abstract = "Background/Aim: To evaluate p16/Ki-67 dual-staining performance for detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in the management of women with minor cervical abnormalities. Patients and Methods: All 759 enrolled patients were tested for cytology, high-risk human papillomavirus (HR-HPV) and dual p16/Ki-67 staining. Results: Positivity rates for HR-HPV and dual staining increased as dysplasia was worsened from non-CIN (37.6% and 0%) to CIN1 (62.5% and 1.6%) and CIN2+ (98.7% and 97.3%), respectively. HPV18 and HPV16 exhibited the highest odds ratios (53.16 and 11.31) in the CIN2+ group. Both p16/Ki-67 dual staining and HR-HPV presented similar sensitivities (97.3% and 98.7%, respectively) for CIN2+ detection. Dual staining specificity, however, was 99.3%, significantly higher compared to HR-HPV testing (52.2%). The utility of dual staining was evaluated in different screening strategies and appeared to reduce the number of colposcopies required for the detection of CIN2+ cases. Conclusion: p16/Ki-67 dual-staining cytology is a surrogate triage biomarker in cytology-based screening programs, with high performance for efficient risk stratification of women with mild cervical abnormalities. © 2022 International Institute of Anticancer Research. All rights reserved."
}