The Application Of C-MYC Gene Amplification In Diagnosis And Treatment Of Cervical Lesions

Objective：Invasive Cervical Cancer (ICC) is one of the malignant tumorswhich seriously threaten the health of women. The incidence rate of ICC is thesecond in female malignancy, which is only lower than breast cancer. Anumber of researches have shown that high-risk human papillomavirus (HPV)persistent infection is the major cause for cervical cancer and precancerouslesions. The HPV would turn to negative in one year for most patients infected.However, it is possible to develop into cervical lesions for ten percent ofpatients infected, which may indicate that there exist other factors in theoccurrence of cervical cancer besides HPV infection. Those influencingfactors may include sexual behavior, the number of birth, immune mechanismand a variety of oncogenes. Therefore, it is urgent to find a reliable indicatoror method to improve the diagnosis of cervical cancer. These would makeearly screening of cervical cancer more reliable. In this study, we aim to detectthe C-MYC gene by the fluorescence in situ hybridization (FISH) in thecervical exfoliated cells, and further to investigate the value of C-MYC geneamplification in diagnosis and treatment for Cervical Lesions.Methods：1000women were examined with liquid-based cytology,high-risk human papillomavirus(HR-HPV) testing using SPR and C-MYCgene detection using fluorescence in situ hybridization(FISH) in The SecondHospital of Hei Bei Medical University.The patients with ASCUS and abovelesion and/or positive HR-HPV and/or positive C-MYC gene amplificationresults were examined by colposcopy,multiple biopsies of cervical quadrantand pathology.Result： The positive rate of HPV infection in1000patients was6.4%(64/1000), the rates of C-MYC gene amplification was2.90%(29/1000),The frequency of CINI,II,III and cervical cancer were 20(2.00%),6(0.06%),8(0.08%)和4(0.04%) respectively in1000patients．1.liquid-based cytology,HPV and C-MYC gene amplification to detect thehigh-grade cervical lesions, sensitivity were94.45%,61.11%,77.78%,specificity were94.39%,95.53%,98.96%. compared with cytology, thesensitivity of C-MYC gene (77.78%) is lower than cytology(94.45%),specificity (98.96%)is higher than cytology (94.39%); comparedwith HPV testing,the sensitivity and specificity of C-MYC gene were higherthan HPV testing, suggesting that the C-MYC gene amplification to detectcervical CINII and high-grade lesions super than SPR-HPV testing,screening of high-grade cervical lesions is meaningful.2. The positive rates ofC-MYC gene amplification were18.75%in HPV positive and1.82%in HPVnegative,the difference was statistically different between the twogroups(X2=61.002, P<0.05).3. In cytology the rates of C-MYC geneamplification were NILM (0.76%),ASCUS (7.41%),ASC-H (16.67%),LSIL(28.57%),HSIL (73.33%), SCCA (100.00%),There was a marked increase ofC-MYC amplification in patients with HSIL and above lesion(X2=304.470,P<0.05).4.In histology,the rates of C-MYC gene amplification wererespectively: normal (10.99%), CINI (25.00%), CINII (50.00%), CINⅢ(87.50%),invasive carcinoma(100.00%). The amplification rate of C-MYCgene grows large with the pathological classification.There was a markedincrease of C-MYC amplification in patients with CINⅡ and abovelesion(X2=33.110,P<0.05). It indicates that C-MYC gene plays an importantrole in the development of cervical cancer,and the relationship with HSIL wascloser.Conclusion：1. The C-MYC gene detection is superior to SPR-HPV testingin cervical CINII and high-grade lesions screening. It is meaningful forscreening high-grade cervical lesions.2. The amplification rate of C-MYCgene increased as a function of the cytology classification, and the value inHSIL and more severe erosions is significantly higher than that of LSIL andbelow the lesion.3. The amplification rate of C-MYC gene grows large withthe pathological classification, and the value in CIN II and above the level of lesion was significantly higher than that of the CINI and NILM. It indicatesthat C-MYC gene plays an important role in the development of cervicalcancer.4. There was a tight correlation among C-MYC amplification, cervicalcytology and histology. The C-MYC gene amplification may be an indicatorto predict prognosis and evaluate the grade of lesion.