Title |
p16INK4a/Ki-67 dual stain cytology for cervical cancer screening in Thika district, Kenya
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Published in |
Infectious Agents and Cancer, August 2015
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DOI | 10.1186/s13027-015-0020-2 |
Pubmed ID | |
Authors |
Caroline Wangari Ngugi, Dietmar Schmidt, Karanja Wanyoro, Hamadi Boga, Peter Wanzala, Anne Muigai, John Mbithi, Magnus von Knebel Doeberitz, Miriam Reuschenbach |
Abstract |
The identification of suited early detection tests is one among the multiple requirements to reduce cervical cancer incidence in developing countries. We evaluated p16(INK4a)/Ki-67 dual-stain cytology in a screening population in Thika district, Kenya and compared it to high-risk human papillomavirus (HR-HPV) DNA testing and visual inspection by acetic acid (VIA) and Lugol's iodine (VILI). Valid results for all tests could be obtained in 477 women. 20.9 % (100/477) were tested positive for HR-HPV DNA, 3.1 % (15/477) had positive VIA/VILI and 8.2 % (39/477) positive p16(INK4a)/Ki-67 cytology. Of 22 women that showed up for colposcopy and biopsy, 6 women were diagnosed with CIN3 and two with CIN2. All women with CIN2/3 were negative in VIA/VILI screening and positive by HR-HPV DNA testing. But HPV was also positive in 91.7 % (11/12) of women with normal histology. p16(INK4a)/Ki-67 cytology was positive in all 6 women with CIN3, in one of the two CIN2 and in only 8.3 % (1/12) of women with normal histology. p16(INK4a)/Ki-67 cytology is an interesting test for further studies in developing countries, since our findings point to a lower fraction of false positive test results using p16(INK4a)/Ki-67 cytology compared to HPV DNA testing in a Kenyan screening population. VIA/VILI missed all histology-proven CIN2/3. |
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