Category Archives: Cervix

p16

October 28, 2017 peferguson

p16 is a marker primary used as a surrogate marker for high risk HPV infection. The physiologic role of p16 when it is expressed leads to cell cycle arrest. Normal levels are below the threshold for detection by immunohistochemical methods (IHC). Sometimes occasional non-proliferating epithelial cells may express p16 by IHC (these cells are usually in the upper aspects of the stratified epithelium.

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Organ Systems, Gynecological, Cervix, Uterus, IHC Panels

Endometrial vs. Endocervical Adenocarcinoma

October 10, 2017 peferguson

Endocervical vs. Endometrial Adenocarcinoma

Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically. The question often comes up as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium. The following antibodies may be helpful in such circumstances:

	Endocervical Adenocarcinoma	Endometrial Adenocarcinoma
Vimentin	Negative (7-8%+)	Positive (70-93%)
CEA	Positive (65-95%)	Usually Negative
ER	Negative (4-20%+, 38% weak)	Strong Positive (67-90%)
p16	Strong & Diffuse Positive (90-100%)	Patchy Positive cells (~35%)
HPV	Positive (67%)	Negative

References

AJSP 2002;26:998

“Endocervical vs. Endometrial Adenocarcinoma: Update on Useful Immunohistochemical Markers.” RT Miller,The Focus ProPath Immunohistochemistry.” April 2003.

Organ Systems, Gynecological, Cervix

Cervix – HGSIL

October 10, 2017 peferguson

High-Grade Squamous Intraepithelial Lesions

p16	Strong diffuse cytoplasmic and nuclear positivity in the vast majority of cells.
Ki67	Markedly increased proliferation indue with positive staining occurring in the upper half of the epithelium (occasionally extending to the epithelial surface.

References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Cervix

Cervix – LGSIL

October 10, 2017 peferguson

Low-Grade Squamous Intraepithelial Lesions

p16	Patchy cytoplasmic and nuclear positivity. Some cases may show diffuse positivity.
Ki67	Variably increased, but should not frequently extend into the upper half of the epithelium.

References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Cervix

Cervix – Reactive

October 10, 2017 peferguson

Reactive Squamous Conditions

p16	Negative to patchy and focally positive.
Ki67	Should show a low proliferation index in a metaplastic lesion, but may be normal to markedly increased in reactive lesions. This is why it should be paired with p16.

References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Cervix

Cervical Adenocarcinoma

October 10, 2017 peferguson

Endocervical vs. Endometrial Adenocarcinoma

Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically. The question often comes as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium. The following antibodies may be helpful in such circumstances:

	Endocervical Adenocarcinoma	Endometrial Adenocarcinoma
Vimentin	Negative (7-8%+)	Positive (70-93%)
CEA	Positive (65-95%)	Usually Negative
ER	Negative (4-20%+, 38% weak)	Strong Positive (67-90%)
p16	Strong & Diffuse Positive (90-100%)	Patchy Positive cells (~35%)
HPV	Positive (67%)	Negative

References

AJSP 2002;26:998

“Endocervical vs. Endometrial Adenocarcinoma: Update on Useful Immunohistochemical Markers.” RT Miller,The Focus ProPath Immunohistochemistry.” April 2003.