predict short time prognosis in low grade cervical- intraepithelial neoplastic lesion

Background and Aim : Background: Screening of Cervical cancer as the most common gynecologiccancer in developing country and preventable one still have some limitation .Recently many researcherwork on immunohistochemistry as a tool to improve screening of cervical intraepithelial neoplasia(CIN);precancerous lesion, but most of them was on cytological sample. The objective of this study was toanalyze the distribution and prognostic capacity of Ki-67 biomarker expression (by immunohistochemistryevaluation) in relationship to HPV status in low-grade cervical intraepithelial lesions (LSIL or CIN1)samples of cervix (by punch biopsy) as an alternative or auxiliary method to current screening method inour geographic region.Methods : This descriptive prospective study included 40 patient with cervical punch biopsy samples ofLSIL diagnoses who was referred to the department of gynecology and oncology of an academic hospitalof Mashhad University of Medical Sciences. Considering to inclusion criteria, Two pathologists reviewedAll samples and performed invitro HR- HPV DNA tests(COBAS) and immunostaining for KI-67 biomarkerfor all samples, the results were compared within the samples and also its prognostic capacity after one yearfollow up for all patientsResults : KI-67 expression was detected in 17 colposcopic sample (49.5%) in scattered expression, in 8cases (20%) with intermediate and in 15 of patient with CIN1 (37.5%) showed high grade (diffuse)expression in the other hand KI-67 expression revealed significant differences between HR-HPV positiveand negative patient (P.value <0.001, MANN WHITNEY U TEST), but no statistical correlation betweenKI-67 expression and the initial colposcopic abnormality that reported by the gynecologist. In present studydue to limited persist disease , there was no detectable cutoff for KI-67 expression and so grading hadbeen used for assessmentConclusion : KI-67 biomarker is recommended as complementary tests not alternative for differentiatingbetween high risks patients with LSIL for best follow up planning thus the low KI-67 / HR-HPV positivepatient could be offer for a less aggressive follow up protocol due to theirs low risk of persistency orprogression; in HR-HPV negative patient this risk is even fewer.