Introduction/Background Interpretation of postmenopausal smears can often be time consuming and difficult. With our study we aimed to evaluate the diagnostic performance of p16/Ki67 immunostaining for detection of high-grade squamous intraepithelial lesion (HSIL) in postmenopausal women with low grade cytology.

Methodology All consecutive ASC-US and LSIL smears in a one-year period were collected and p16/Ki-67 immunostaining was performed retrospectively. All patients were followed-up for the period of six years. Results were compared with histology results or long-term cytology follow-up in cases with no biopsy.

Results 270 postmenopausal patients were included in the study. 241 patients had their Pap smear interpreted as ASC-US (89.3%) and 29 patients had LSIL (10.7%). 20 patients (7.4%) had histologically confirmed HSIL (CIN2+). The sensitivity of p16/Ki-67 immunostaining for the detection of CIN 2+ was 57.0% and for the detection of CIN 3+ 85.0%. The specificity for the detection of CIN 2+ and CIN 3+ was 94.3% and 94.6%, respectively.

Conclusion With high specificity levels for the detection of CIN 2+ and CIN 3+, p16/Ki67 immunostaining is useful for postmenopausal women with low grade cytology and could be used as a triage method for colposcopy.

Disclosure Nothing to disclose