p16INK4a como predictor de evolución clínica en pacientes con neoplasia intraepitelial cervical de bajo grado (NIC-I): serie de casos

the morphological diagnosis of low grade-cervical intraepithelial neoplasia (cin-1) can not determine its true risk of progression to cervical cancer, leading to strict adherence to a high number of patients whose lesions, most will return spontaneously. the detection of p16ink4a has been proposed as biomarker to differentiate between productive infection self-limiting by human papillomavirus (hpv) and cell transformation induced by oncogenic strains of hpv, however, it is necessary provide evidence of its predictive capacity. we present a series of 14 cases of cin-1 with immunohistochemical detection of p16ink4a in cervical biopsy (8 positive and 6 negative), whose retrospective review of medical records of more than 12 months of cyto-histopathological follow, can describe spontaneous regression in all cases p16ink4a negative and in 3 cases p16ink4a positive (37.5%). the findings in this series of cases coincide with that described in previous studies that has been demonstrated the negative predictive value of the marker to exclude risk of progression-persistence and avoid follow-ups and unnecessary treatments. additionally, these indicates weaknesses to evaluate about the positive predictive value of the test, by not discriminating factors independent of cellular transformation, determining the progression-persistent cin-1, such as genetic and / or immunologic variables of the host.