Expression of Ki-67 and squamous intraepithelial lesions are related with HPV in endocervical adenocarcinoma

To estimate the association between human papillomavirus (HPV) status and the expression of p53, Ki67 and bcl-2 in cases of endocervical adenocarcinoma, and the relation with squamous intraepithelial lesions (SIL) and age, 229 cases were selected, treated between 1995 and 2003 in the Hospital Nossa Senhora da Conceicao. All samples were evaluated by polymerase chain reaction to determine HPV status. Immunohistochemical technique was used to investigate the expression of p53, Ki-67 and bcl-2. The joint occurrence of endocervical adenocarcinoma and SIL were estimated too. In the 229 evaluated cases, 182 cases (79.48%) were associated with the presence of the HPV. The most common types were HPV18 ( 93 cases - 51.09%) and HPV16 ( 62 cases - 34.06%). Expression of Ki-67 (p = 0.009) and the presence of SIL (p = 0.018) were associated to HPV infection. Expression of p53 (p = 0.647) and bcl-2 (p = 0.671) were not related to HPV status. The mean age of the patients was 53.2 years, without clear correlation between age group and HPV (p = 0.095). The presence of HPV, especially type 18 in endocervical adenocarcinoma suggests that this agent can be an important cofactor in the development and progression of glandular neoplasms of the uterine cervix. The joint occurrence of endocervical adenocarcinoma and SIL may support this hypothesis. HPV may promote an increased proliferation index in endocervical adenocarcinoma, shown by the expression of Ki-67.