P53 IMMUNOSTAINING AND HPV DNA DETECTION BY PCR IN CERVICAL INTRAEPITHELIAL NEOPLASIA - CLINICAL IMPLICATIONS OF A COMBINATED EVALUATION

We analysed p53 immunoreactivity and clinical outcome in a series of c ervical intraepithelial neoplasias (GIN), with respect to HPV DNA posi tivity. Cervical biopsy samples were obtained from 86 women who attend ed our Colposcopic Service from January 1993 to June 1993 due to abnor mal papsmear suspicious for CIN and/or human papillomavirus infection. Forty-one women with histologically confirmed CIN were included in th e study. p53 positivity was immunohistochemically detected by monoclon al antibody anti-human p53 (pAb D0-7, Dako Denmark; dilution 1:50), an d expressed as the percentage of positive cells. p53 positivity was ob served in 78% of CIN lesions. In particular, all the HPV DNA-negative dysplasias expressed p53 protein while only 12 out of 21 (57%) HPV DNA -positive were p53 immunoreactive; (P=.003) the p53 immunostaining was also significantly higher in HPI DNA-negative than in positive CIN (P =.049). By analysing p53 positivity with respect to clinical-pathologi c evolution of the disease, among HPV DNA-negative cases, progressive dysplasia had significantly higher values of p53 immunostaining when c ompared to persistent and/or regressive lesions (P=.002). These findin gs imply that p53 immunostaining, when analysed with respect to HPV DN A status, may help to understand the behavior of dysplastic lesions an d define their therapeutic approach. Extensive p53 staining in HPV DNA -negative CIN is probably correlated with a high risk of progression.