Evidence map›Paper›PMID 19261387›Full record

SynthesisCancer treatment reviews2009

p16(INK4a) immunostaining in cytological and histological specimens from the uterine cervix: a systematic review and meta-analysis.

I Tsoumpou, M Arbyn, M Kyrgiou, N Wentzensen, G Koliopoulos, P Martin-Hirsch, V Malamou-Mitsi, E Paraskevaidis

Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cancer treatment reviews, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02522585 (Predictive Value of p16 and Ki-67 Immunohistochemical Staining and NK Cells in Expectant Management of Cervical Intraepithelial Neoplasia Grade 2), which is not on this map. Cited by 94 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
94citing papers in PubMed, 8 pooled it
20.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02522585 completednot on this mapstarted 2011, after this paper: background citation

Predictive Value of p16 and Ki-67 Immunohistochemical Staining and NK Cells in Expectant Management of Cervical Intraepithelial Neoplasia Grade 2

TypeobservationalSponsorParc de Salut MarRan2011 to 2015Enrolled100ConditionsCervical CancerArmsConservative management
3 · Its place in the literature

Who cites it

94 citing papers in PubMed, 8 syntheses or guidelines pooled it, 321 citations in OpenAlex.

  1. Pooled it
  2. p16 immunostaining in histological grading of anal squamous intraepithelial lesions: a systematic review and meta-analysis.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2018
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34 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 4 countries.

I TsoumpouDepartment of Obstetrics and Gynaecology, St Mary's Hospital, CMMC University Hospitals, Manchester M13 0JH, UK.
M Arbyn
M Kyrgiou
N Wentzensen
G Koliopoulos
P Martin-Hirsch
V Malamou-Mitsi
E Paraskevaidis
University of Ioannina · GRInstitut Scientifique de Santé Publique · BELancashire Teaching Hospitals NHS Foundation Trust · GBUnited States Department of Health and Human Services · USWest Middlesex University Hospital · GB

Funding

Intramural NIH HHS Z99 CA999999
6 · The paper itself

Abstract

backgroundP16(INK4a) is a biomarker for transforming HPV infections that could act as an adjunct to current cytological and histological assessment of cervical smears and biopsies, allowing the identification of those women with ambiguous results that require referral to colposcopy and potentially treatment. MATERIAL AND

methodsWe conducted a systematic review of all studies that evaluated the use of p16(INK4a) in cytological or histological specimens from the uterine cervix. We also estimated the mean proportion of samples that were positive for p16(INK4a) in cytology and histology, stratified by the grade of the lesion.

resultsSixty-one studies were included. The proportion of cervical smears overexpressing p16(INK4a) increased with the severity of cytological abnormality. Among normal smears, only 12% (95% CI: 7-17%) were positive for the biomarker compared to 45% of ASCUS and LSIL (95% CI: 35-54% and 37-57%, respectively) and 89% of HSIL smears (95% CI: 84-95%). Similarly, in histology only 2% of normal biopsies (95% CI: 0.4-30%) and 38% of CIN1 (95% CI: 23-53%) showed diffuse staining for p16(INK4a) compared to 68% of CIN2 (95% CI: 44-92%) and 82% of CIN3 (95% CI: 72-92%).

conclusionAlthough there is good evidence that p16(INK4a) immunostaining correlates with the severity of cytological/histological abnormalities, the reproducibility is limited due to insufficiently standardized interpretation of the immunostaining. Therefore, a consensus needs to be reached regarding the evaluation of p16(INK4a) staining and the biomarker needs to be assessed in various clinical settings addressing specific clinical questions.

Indexed as

AlphapapillomavirusBiomarkersBiomarkers, TumorBiopsyCervix UteriColposcopyCyclin-Dependent Kinase Inhibitor p16Cytological TechniquesFemaleHistological TechniquesHumansImmunohistochemistryNeoplasm ProteinsPapillomavirus InfectionsPredictive Value of TestsProspective StudiesBiomarkersBiomarkers, TumorCyclin-Dependent Kinase Inhibitor p16Neoplasm Proteins

Identifiers

PMID19261387
PMCPMC2784486
OpenAlexW2115240529

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.