The Correlation Among The Expression Of Human Telomerase Gene (hTERC), Thinprep Cytologic Test (TCT) And Human Papillomavirus (HPVs) In Cervical Lesions

Objective1. To discuss the clinical significance of the hTERC gene as the indicators of the trends in the occurrence of cervical cancer by studying the active expressions of the hTERC gene in each grade of TCT.2. To discuss the active expressions of the hTERC gene associateed with the infection of HPV, so to eraly find the occurrence of cervical cancer .3. To discuss the active expressions of the hTERC gene in each step of cervical lesions, to find the eralier diagnoses,further progresstion and proper therapies of cervical intraepithelial neoplasia(CIN). Methods The study was divided into two parts as follows.The first part:In this part, we analyzed sixty-nigh patients with TCT test from January 2008 to January 2009 in gynecological of Jinnan Military General Hospital. We selected 17 patients whose cytology were NILM , and 52 patients whose cytology were positive(We regarded the ASC-US and over the ASC-US as positive cases ). All the patients carried on the biosy under the guaidane of colposcopy test.The pathology results were the gold and final standard.The group of 20 cervicitis patients was negative comparation, the group of 24 cervical cancer patients was positive comparation and the group of 25 CIN patients was studied. All the patients carried on the HPV DNA test by Flow through hybrization and gene chip, hTERC test by FISH.The second part:To discuss this part as follows :1. Compared the TCT results with HPV results; 2. Compared the expressions of hTERC with TCT results;3. Compared the expressions of hTERC with HPV results ;4. To study the expressions of hTERC in pathology results . Result The results of the frist part: The examined 69 patients of this study, NILM was 17 cases,ASC-US was 20 cases, LSIL was 6, HSIL was 8, SCC was 18;High-risk HPV(HR-HPV) infection was 39 cases,low-risk HPV infection was 1 case, non HPV infection was 29 cases. Cervicitis was 20 cases, CINⅠ8 cases, CINⅡ7cases, CINⅢ10 cases, cervical sqmous carcinoma 24 cases.The results of second part:1. The results of TCT and HPV:the more fearful the change of the cytology, the more fearful of the HR-HPV infection.Compared the group of NILM (5.9%,1/17)with the group of ASC-US and more than it(75.0%,39/52),they have the signifiant difference(χ2=27.5, P<0.05).In the group of ASC-US and more than it,the two of them have no signifiant difference(P>0.05).2. The results of TCT and hTERC: the more fearful the change of the cytology ,the more active expressions of hTERC gene , Compared the group of NILM(0/17) with the group of ASC-US and more than it(42/52),they have the signifiant difference(χ2=44.7,P<0.05). The expressions of hTERC gene with group of ASC-US was 55.0%,LSIL was 83.3%,HSILand SCC was 100%.The group of ASU-US and LSIL have no signifiant difference(P>0.05),but with HSIL,SCC have signifiant difference(P<0.05).The group of LSIL and HSIL,SCC have no signifiant difference(P>0.05).The group of HSIL and SCC have no signifiant difference(P>0.05).3. The results of hTERC and HPV: the patients with infection of HR-HPV,the active expressions of hTERC gene were(79.5%) higher than the patients who have non HPV infection(27.6%),they have the significant difference (χ2=26.0,P<0.05 ) .The active expression of hTERC gene has inseparable correlation with HR-HPV.4. The results of hTERC gene expressions in pathology results :the deeper of the pathological changes ,the more active expressions of hTERC gene,the group of cervicitis was no the active expression of hTERC gene,the CINⅠwas 75.0%,the CINⅡ/Ⅲwas 76.5%,the cervical cancer was 87.5%.The group of cervicitis and CIN have the significant difference(χ2=39.5,P<0.05). The group of CINⅠand CINⅡ/Ⅲhave no signifiant difference(P>0.05).The group of CIN and cervical cancer have no signifiant difference(P>0.05).Conclusions1. hTERC gene was the complement of the cytology, and the amplification of hTERC gene can predict the malignant potential of the CIN cell.2. The active expressions of hTERC gene has inseparable correlation with HR-HPV.3. hTERC gene can be the powerful method besides the clinical"three-step"test and HPV test . Its active expressions can be the indicators of the progress uptrending for CIN.And it can guide the proper therapy for CIN.The patients of CIN whose hTERC gene have active expressions should be paid attention to diagnose and therapy in clinical works.