p16INK4a in the differential diagnosis between cervical atrophy and high grade cervical intraepithelial neoplasia (CIN II): report of a case

Introduction: Uterine cervix atrophic changes in postmenopausic women can mimic premalignant lesions, difficulting colposcopy and citopathology diagnosis. Immunohistochemical detection of p16INK4a could be useful as a diagnostic tool to differentiate between these changes. However, clinical evidence must be provided in order to accept this technique. Case report: Postmenopausic patient with insatisfactory colposcopy and cyto- hystopathology findings suggestive but not conclusive of high grade cervical intraepithelial neoplasia. p16INK4a immunohistochemical detection was negative and hystology of diagnostic/therapeutic conization did not find intraepithelial lesion or malignancy. This case is a con-tribution favouring p16INK4a as a differential biomarker between atrophic and premalignant changes in order to avoid unnecessary interventions. Both patient's informed consent and Universidad de Cartagena and E.S.E. Clinica "Maternidad Rafael Calvo" scientific subdirection institutional consent were obtained for the writing of this presentation.