Detection Of Genomic Amplification Of Human Telomerase Gene (hTERC) In Cytologic Specimens In The Screening Of Cervical Lesions

ObjectivesTo evaluate the significance of detecting human telomerase gene(hTERC) amplification in the screening of cervical lesions by using fluorescence in situ hybridization(FISH).MethodsFrom January to December 2008,we took 100 patients who came to Qilu hospital of Shandong University for cervical lesions screening or treatment as research objects.Everyone had to supply cytological specimens for FISH detection of the amplification of hTERC gene.People also have to offer their thinprep cytology test(TCT) results and histological results of cervical biopsy.Those who had detected the infection of high risk human papillomavirus(HR-HPV) would offer the virus conditions.At last,the relationship between TCT,HR-HPV and histological results with the amplification rate of hTERC gene was analyzed.ResultsOf 100 objects,20 with normal TCT results were chosen to set threshold value. In our research,the threshold value was≥9%,i.e.people whose gene amplification rate was higher than 9%was considered amplification positive.(1)Following TCT diagnosis,gene amplification of hTERC were found in 20%(1/5) of inflammatory specimens,54.55%(6/11) of ASCUS,64.71%(11/17) of LSIL,90%(9/10) of ASC-H,93.94%(31/33) of HSIL and 100%(4/4) of SCC.There were significant differences in gene amplification rate of inflammation,ASCUS,LSIL and HSIL (P＜0.05).(2) A total of 44 patients had offered HR-HPV results.The infection rate of different histological grades were CIN1 50%(4/8),CIN2 94.4%(17/18 ),CIN3 100%(12/12) and SCC 83.33%(5/6).There were no difference in detection sensitivity between gene amplification and HR-HPV infection rates(P＞0.05).(3) Following different histological grades,gene amplification rates were CIN1 31.25% (5/16),CIN2 77.27%(17/22),CIN3 91.30%(21/23) and SCC 100%(19/19). Significant differences exist in CIN1 and CIN2-3,SCC.Cell numbers with gene amplification were(9.44±6.50 ),(17.38±7.08 ) and(32.95±15.75 ) in low grade lesions,high grade lesions and SCC patients,respectively.There were significant differences in each pair wise(P＜0.0001).For high grade CIN lesions,the detection sensitivity of TCT and FISH methods were 42.22%(19/45) and 84.44%(38/45) respectively,with high statistic significance.(P＜0.0001).ConclusionsFISH detection can be used in clinical practice.The detection of hTERC gene amplification can serve as an assist method for cytology screening and improve the detection efficiency.There was no difference in sensitivity between hTERC gene amplification and HR-HPV infection detection.Both had higher sensitivities, especially for high grade lesions.CIN1/2 lesions which were hard to distinguish can use hTERC gene amplification detection as an adjunct method.People with obvious amplification should be closely followed up.