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Introduction/Background Cervical cancer remains a significant cause of cancer-related mortality among women, particularly in developing countries. This study aimed to evaluate the potential of p16/Ki67 dual staining as a method for enhancing cervical cancer triage in VIA-positive patients. Methodology This prospective study was conducted at a tertiary care hospital over 18 months. Premenopausal women aged 30–50 years were opportunistically screened for cervical cancer using Visual Inspection with Acetic Acid (VIA). VIA-positive patients were subjected to colposcopy and guided biopsy. p16/Ki67 dual staining was performed on alcohol-fixed cervical smears using antibodies against p16 and Ki67 antigens. Data was analyzed using SPSS version 22, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of p16, Ki67, and combined p16/Ki67 were calculated using histopathology as a gold standard. Results Out of 700 screened women, 70 were VIA-positive. Histopathological examination revealed various cervical lesions, including benign findings (47%), Cervical Intraepithelial Neoplasia (CIN) grade 1 (25.7%), CIN 2 (15.7%), CIN 3 (7.1%), and squamous cell carcinoma (4.3%). VIA demonstrated moderate diagnostic accuracy and PPV for detecting ≥CIN1 and ≥CIN2 lesions. Liquid-Based Cytology exhibited higher sensitivity for detecting cervical lesions. The combined evaluation of p16ink4a and Ki67 expression revealed promising insights into cellular changes associated with VIA-positive cases. Conclusion The study underscores the potential of p16/Ki67 dual staining as a valuable tool for enhancing cervical cancer triage. VIA remains a cost-effective screening method, and the introduction of p16/Ki67 immunostaining holds promise for accurate triaging of VIA-positive patients. This approach can potentially reduce overtreatment and improve healthcare cost-efficiency. Further research is needed to refine the diagnostic accuracy and optimize the management of cervical lesions, and broader adoption of p16/Ki67 immunostaining is recommended for triaging VIA-positive women. Disclosures None.
Mishra et al. (2024) studied this question.