宫颈癌是全球第四大常见生殖道癌症，也是全球女性肿瘤相关死亡原因中第四大常见死因。鳞状细胞癌是最常见的类型，约占宫颈癌所有病理类型的 90%。细胞周期蛋白依赖性激酶抑制剂 2A (CDKN2A；p16) 是位于 9 号染色体上的基因，编码抑制细胞周期蛋白依赖性激酶 4 和 6 的蛋白 (P16)，而细胞周期蛋白依赖性激酶 4 和 6 是视网膜母细胞瘤蛋白的抑制剂；最终结果是视网膜母细胞瘤蛋白重新激活，细胞周期停滞在 G1 期。因此，癌细胞内p16蛋白的表达可能预示着良好的预后。软标记物的存在非常重要，它可以检测明显临床和放射学早期可切除阶段的宫颈癌中隐藏的晚期阶段，并可以取代危及生命的术前淋巴结切除术。在其他癌症中表达时与良好预后相关的 P16 蛋白是否可以成为这种软标记？本研究的目的是估计细胞周期蛋白依赖性激酶抑制剂 2A (CDKN2A; p16) 免疫组织化学阳性染色在鳞状细胞癌中的患病率宫颈并将其阳性率与临床和放射学疾病阶段相关联。对来自 Al Shatby 大学医院妇科肿瘤科的 60 名浸润性鳞状细胞宫颈癌患者进行了一项分析性横断面观察性前瞻性和回顾性研究，这些患者在获得书面同意后，经亚历山大医学院机构伦理委员会批准后。纳入标准包括2019年1月至2022年6月前瞻性和回顾性宫颈浸润性鳞状细胞癌的所有患者，这些患者通过楔形、穿孔和锥形活检诊断，随后进行组织病理学检查，证实诊断并显示鳞状细胞癌的分级和类型。对所有病例进行临床检查、阴道超声扫描、计算机轴向断层扫描和磁共振成像，并记录数据用于临床和放射学分期。对所有数据进行收集、编码、制表和统计分析，以估计研究病例中 p16 阳性的患病率，并将其阳性率与临床和放射学疾病阶段相关联。关于 p16 免疫染色的患病率，34 例 (56.7%) 呈阳性相比之下，26 例（43.3%）呈阴性。考虑到早期可切除阶段和晚期不可切除阶段与P16阳性和阴性染色的相关性，结果显示：32例（53.3%）可切除，其中30例（88.2%）P16免疫染色阳性2例（7.7%）。 %) P16 免疫染色阴性，而不可切除病例有 28 例（46.7%），4 例（11.8%）仅 P16 阳性，而 P16 免疫染色阴性有 24 例（92.3%），因此大多数早期可切除病例为 P16 阳性免疫染色和大多数晚期不可切除阶段病例的 P16 免疫染色呈阴性。早期可切除阶段与 P16 免疫染色阳性之间存在显着正相关，晚期不可切除阶段与 P16 免疫染色阴性之间也存在显着正相关性 (p = 0.000)。本研究得出结论，宫颈鳞状细胞癌中 P16 免疫染色阳性患病率为 56.7%，其阳性染色与早期可切除的临床和放射学疾病阶段高度相关。© Federation of Obstetric

Cervical cancer is the fourth most common genital tract cancer and fourth common cause of death among the causes of neoplasm-related mortality in women worldwide. Squamous cell carcinoma is the most common type and constitutes about 90% of all pathological types of cervical cancer. Cyclin-dependent kinase inhibitor 2A (CDKN2A; p16) is a gene that is located on chromosome 9 that encodes a protein (P16) that inhibits cyclin-dependent kinases 4 and 6 which are inhibitors of retinoblastoma protein; the net result is reactivation of retinoblastoma protein and arrest of cell cycle in G1 phase. So, expression of p16 protein within cancer cell may denote good prognosis. The presence of a soft marker that can detect hidden advanced stages in apparently clinically and radiologically early resectable stages of cervical cancer and can replace life-threatening preoperative lymphadenectomy is of great importance. Is P16 protein which when expressed is associated with good prognosis in other cancer can be this soft marker?The aim of this study is to estimate the prevalence of cyclin-dependent kinase inhibitor 2A (CDKN2A; p16) immunohistochemistry positive staining in squamous cell carcinoma of the cervix and to correlate its positivity  to clinical and radiological disease stage.An analytical cross-sectional observational prospective and retrospective study was conducted on 60 invasive squamous cell cervical cancer patients from gyne-oncology unit at Al Shatby university hospital after taking a written consent and following approval by Alexandria medical school institutional ethics committee. Inclusion criteria included all patients with invasive squamous cell carcinoma of the cervix prospective and retrospective from January 2019 till June 2022 diagnosed by taking wedge, punch and cone biopsy followed by histopathological examination that confirmed the diagnosis and showed grading and types of squamous cell carcinoma. Clinical examination, vaginal ultrasonographic scanning, computerized axial tomography and magnetic resonance imaging were carried out to all cases, and data were recorded for clinical and radiological staging purposes. All data were collected, coded, tabulated and statistically analyzed to estimate the prevalence of p16 positivity in the study cases and to correlate its positivity with clinical and radiological disease stage.In relation to prevalence of p16 immunostaining, 34 cases (56.7%) were positive in comparison with 26 cases (43.3%) being negative. Considering correlation between early resectable stage and late nonresectable stage with P16 positive and negative staining, the result showed the following: 32 cases (53.3%) were resectable, 30 cases (88.2%) of them were P16 positive immunostaining compared to 2 cases (7.7%) being P16 negative immunostaining while nonresectable cases were 28 cases (46.7%), 4 cases (11.8%) only were P16 positive compared to 24 cases (92.3%) being P16 immunostaining negative, so most of early resectable stage cases were P16 positive immunostaining and most of late nonresectable stage cases were P16 negative immunostaining. There is a positive significant correlation between early resectable stage in relation to positive P16 immunostaining, and the same was present between late nonresectable stage and negative P16 immunostaining (p = 0.000).The present study concluded that P16 positive immunostaining prevalence in cervical squamous cell carcinoma was 56.7% and its positive staining is highly correlated with early resectable clinically and radiologically disease stage.© Federation of Obstetric & Gynecological Societies of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.