Background:Minichromosome maintenance proteins (MCM) are highly expressed in actively replicating cells. The need for
biological markers for cervical carcinoma and its precursor lesions is emerging. Our main aim was to determine the
immunohistochemical expression of MCM-2 in HIV-positive and -negative dysplastic cervical specimens.
Methods:Immunohistochemical analysis of MCM-2 was performed in a total of 352 cervical TMA specimens of normal
control, low-grade CIN, high-grade CIN and invasive tumor. 38 specimens were from HIV-positive women. A receiver
operating characteristic (ROC) curve was constructed to determine the best cutoff to diagnose high-grade CIN and invasive
cervical cancer.
Results:In the progression from normal epithelium to high-grade CIN and invasive tumor we found significant differences
in the MCM-2 expression (p,0.05). Based on the ROC curve of 80% with an area under the curve (AUC) of 0.78, expression of
MCM-2 to diagnose high-grade CIN and invasive tumor resulted in sensitivity of 81%, specificity of 66%, a positive predictive
value (PPV) of 86% and a negative predictive value (NPV) of 57%. HIV-positive cervices revealed a decreasing expression of
MCM-2 in both LGCIN and HGCIN compared with HIV-negative specimens (p,0.0001).
Conclusions:The present study suggests that immunohistochemical MCM-2 may not be a promising biomarker for
diagnosing high-grade CIN and invasive cance