Effect of p16 Immunohistochemistry on Interobserver Agreement in Cervical Biopsy Histopathology: A Structured Literature Review - Preliminary Synthesis

Preliminary synthesis - Search date 20 October 2026. PubMed search query: (p16 OR p16INK4a) AND (cervix OR cervical) AND (interobserver OR reproducibility OR agreement) - 326 records retrieved as recorded from PubMed results page. PubMed Central: 11,868 results reported for broad search - PMC not screened record-by-record, supplementary use only. Exact query used to obtain PMC figure should be recorded separately if it differed from PubMed query.

The full systematic screening of all retrieved PubMed records was not completed. Four publications were selected for preliminary synthesis through the literature identification and reference-checking process. This selection is not intended to represent a completed systematic review.

Four publications for preliminary synthesis:
1. Reuschenbach et al. 2014 - Systematic review and meta-analysis of 5 articles - CIN2+ classification - Pooled estimate H&E alone κ=0.41 vs H&E+p16 κ=0.73 - pooled estimate, not direct primary study
2. Tao et al. 2024 - Dichotomised <HSIL vs HSIL+ - H&E alone κ=0.79 vs H&E+p16 κ=0.84 - small increase
3. Pacchiarotti et al. 2014 - Population-based - Five-category κ=0.52 vs 0.48, Two-category κ=0.75 vs 0.70 - No improvement with routine staining
4. Stoler et al. 2018 CERTAIN study - per abstract 1,100 biopsies, 70 pathologists, 19,250 initial H&E reads - κ=0.58 vs 0.73 - Improved reliability with adjunctive p16

Literature-based only, no patient data. References consistent with abstracts, full texts still need checking. Not a completed systematic review. Does not guarantee NHS portfolio 8 points. Save as preliminary for further verification.

DOI reserved: 10.5281/zenodo.23506185