Expression of Ki 67 and human papilloma virus 16 with risk factors in cervical pre malignant and malignant lesions

Abstract

Introduction: The present study was conducted to assess immunohistochemical expression of Ki-67 and HPV 16 in premalignant and malignant lesions of cervix. It was also intended to study the risk factors which may be associated with these lesions in Uttarakhand state of India. Material and Method: The study including premalignant and malignant lesions of cervix diagnosed over period of one year. Immunohistochemical staining on paraffin blocks for all cases and controls were done for HPV 16 and Ki-67. Ki-67 score was quantified depending on the percentage of positive cells and was statistically analyzed in association with HPV expression. Results: The study included 50 cases of premalignant and malignant cervical lesions and 50 controls. 87.2% of the HPV 16 positive cases were also positive for Ki-67 expression which was statistically significantly higher in comparison to controls. Ki-67 expression was negative in all the controls while 90% of cases showed positivity for Ki-67. The malignant lesions of cervix show a significantly higher grade of Ki-67 expression in comparison to premalignant lesions (p value< 0.001). Conclusion: Low socioeconomic and education status, smoking (either active or passive), early age of sexual contact and first conception with high parity were associated with increased risk of cervical premalignant and malignant lesions in this region of India. Ki-67 plays an important role in carcinogenesis of cervical cancer in association of HPV16. The increase of immunopositivity of Ki-67 with the severity of lesions suggests its use in stratification of premalignant and malignant lesions of cervix.