The Expression And Clinical Significance Of Hterc In Cervical Cancer And Cervical Intraepithelial Neoplasia

Objective: To explore the expression and the clinical significance ofhTREC gene in normal cervix and cervical lesions.Methods: the samples Collected from1000cases of patients fromNov,2010to Jul,2011were analysed using TCT、HPV and FISH to detecthTERC gene,for any positive index,the patient was going to Colposcopicbiopsy，regarding the pathologic results as the golden standard，to compare thehTERC gene amplication in all levels of cervical lesions，using sensitivity、specificity、positive predict value、negative predict value、Youden index andthe area under the ROC curve method to evaluation accuracy of TCT andFISH on patients with high-grade cervical lesions and cervical.Results:1The percentage of amplication hTERC gene in1000cases was3.2%，thepercentage of normal samples，ASCUS，ASC-H，LSIL，HSIL，cervical cancerwere0.87%、10.71%、25.00%、26.67%、73.33%、100%，the ASCUS wassignificantly higher than mormal(p＜0.05)，the HSIL and cervical cancerwere significantly higher than ASCUS、ASC-H and LSIL(p＜0.05)，the cancercannot show extra copies of hTERC gene when compared with HSIL，similarly ASCUS and LSIL.2122cases were tested by Colposcopic pathological biopsy，32of whomshowed extra amplication of hTERC gene.14.77%of normal samples，25.00%of CINI，81.25%of CINII-III，100%of cervical cancer showed extracopies of3q，CINII-III were significantly higher than CINI(p＜0.05).3The sensitivity、specificity、positive predict value、negative predict value、Youden index of hTERC for predicting progression CINII-III and cervicalcancer were83.33%、83.65%、46.88%、96.67%、0.67，TCT were88.89%、99.04%、94.12%、98.10%、0.88，the area under ROC curve of hTERC and TCT were0.835and0.940，they coulde also screen CINII-III and cervicalcancer accurately，TCT was better than hTERC.4In normal cells，the green（CSP3）and red （hTERC）signals showed asCSP3：hTERC=2:2，the abnormal M：N（M＞＝2，N＞2），in low-gradecervical lesions，M and N were often less than five，on the contrary，more thefive in high-grade；the proportion of abnormal cells with extra3q in normal、CINI、CINII-III and cervical cancer were9.15%、11.25%、32.92%and35.00%，there was statistical significance(p＜0.05).5In15cases of LSIL，11of them hadnot hTERC amplication，8were chronicinflammation，3were CINI；4of them showed extra3q，their histologicalresult and hTERC amplication were inflammation-10%、CINI-13%、CINII-10%、CINIII-40%.Conclusion:1The percentage of amplication hTERC gene and the proportion of abnormalcells with extra3q increased with the cervical lesion grade.2while with high sensitivity and high specificity，h-TERC test made aneffective methods to improve the existing detective accuracy.3hTERC can shunt better in LSIL.