Which dual stain predicts high-grade cervical tumors?

• A. HPL/CEA
• B. Napsin A/CK20
• C. p16/Ki-67
• D. p16/CK20

Answer: (C)

The key idea is using biomarker co-expression to identify transforming HPV infections that drive high-grade cervical neoplasia. p16 overexpression happens when HPV E7 disrupts the Rb pathway, signaling HPV-related transformation. Ki-67 marks cells that are actively proliferating. When both markers appear in the same cell, it shows an abnormal, high-level proliferative state driven by HPV—precisely what underlies high-grade CIN and cervical cancer. This makes the p16/Ki-67 dual stain a strong predictor of high-grade lesions, more informative than either marker alone or other dual stains. The other pairs serve different diagnostic roles and don’t specifically indicate high-grade cervical neoplasia in the same direct way.