Búsqueda del marcador de progresión p16ink4a en las lesiones intraepiteliales escamosas cervicales en mujeres de Cartagena de indias

Contenido principal del artículo

Álvaro Álvarez Coneo
Lía Barrios García
Orlando Borré Arrieta
Octavio Arzuza Navarro

Resumen

Introducción y objetivo: numerosos marcadores han sido utilizados en el estudio de la displasia cervical, en este grupo se destaca p16INK4a, una proteína que inhibe las quinasas dependientes de ciclinas 4 y 6 por lo que se considera supresor de tumores. Se  ha observado inactivación de esta proteína en cánceres y se ha asociado su  sobreexpresión en las lesiones cervicales precursoras. Este estudio busca demostrar la  presencia del marcador p16INK4a en Lesiones Intraepiteliales Escamosas diagnosticadas por biopsia como indicador de riesgo de progresión, de las lesiones de bajo grado, a lesiones de
alto grado y cáncer.
Materiales y métodos: fueron seleccionadas 37 biopsias de pacientes con Lesión intraepitelial escamosa de bajo o alto grado, que asistieron a consulta de colposcopia en la Clínica de Maternidad Rafael Calvo, con resultado de citología anormal, entre marzo 2006 - 2008, La colposcopia se realizó con el equipo MORREL con zoom de aumento de 4x a 40x y la biopsia se informó según Richard (NIC I-NIC II Y NIC III) homologada e.g. Bethesda 2001 (Lesión Intraepitelial Escamosa de Bajo Grado y de Alto Grado. LIE). Para la inmunohistoquímica, se tomaron cortes (4 μm) desparafinados a los que se agregó anticuerpo monoclonal anti- p16INK4a, dilución 1:20 (Clon E6H4, Dako Cytomation), y se reveló la reacción con un sistema de estreptavidina peroxidasa. El contraste se realizó con Hematoxilina. Se interpretó según los criterios de Klaes. Los datos fueron analizados con SPSS 12.0. X2 se utiliza para determinar diferencias significativas entre los resultados de la colposcopia, la biopsia y la inmunohistoquímica.
Resultados: de los 37 casos, 24 fueron positivos al marcador (45,5%) en LIE de bajo grado y 93,3% en LIE alto grado. La presencia del marcador se correlacionó significativamente con las LIE alto grado evaluadas por biopsia (Gold-standard).
Conclusiones: p16INK4a se encuentra presente en el epitelio con displasia cervical, sobre todo en las Lesiones de Alto Grado. Las Lesiones de bajo grado positivas para marcador p16 posiblemente tienen mayor riesgo de evolucionar a lesiones de alto grado y cáncer.  Rev.cienc.biomed.2010; 1 (2): 208 - 216

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