The Correlation Of LCT、HPV、hTERC、hTERCgene And C-MYC Gene In The Screening Of Cervical Cancer

Objective: To evaluate the application of Liquid-Based Cytology Test (LCT), human papillomavirus(HPV) examination, human telomerase RNA component(hTERC)gene and C-MYC genedetection in cervical cancer screening as to get a more effective screening program. To explore theclinical significance of amplification of hTERC gene and C-MYC gene in patients with cervicaldiseases.Methods: Cervical specimens of955patients were collected for cervical cancer screening incervical clinic of Shenzhen People’s Hospital from September2010to September2011and allundertaken LCT、HPV (SPR method)、hTERC gene and C-MYC gene detection (FISH) respectively.If any one of the four examinations above was positive, colposcopy and cervical biopsy were done.As histopathology being the final diagnosis (the gold standard), sensitivity, specificity, Youdenindex and the coincidence rate were evaluated when the four examinations were applied alone orcombined. According to histology, patients were divided into two groups: high-grade cervicallesions and low-grade cervical lesions. According to LCT, patients can also be divided into twogroups: NILM/ASCUS group and LSIL/HSIL group.Results: Our patients had an average age of38±8. Of them,114had abnormal LCT (11.9%);160were HPV positive (16.8%);40had positive hTERC gene abnormal amplification (4.2%);37hadpositive C-MYC gene abnormal amplification (3.9%).208patients with any positive result of thefour examinations undertaken routine colposcopy and cervical biopsy. Of those,47hadinflammatory lesions,95had wart,24CINⅠ(cervical intraepithelial neoplasia,CIN),20CINⅡ,19CIN Ⅲ,3had squamous cervical carcinoma(SSC). As with one examination to diagnosehigh-grade cervical lesions, HPV has the highest sensitivity (100.0%), the specificity of hTERCgene and C-MYC gene were89.2%,89.8%respectively. As with the combination of any twoexaminations, hTERC gene+C-MYC gene got the highest Youden index (0.498) and the coincidence rate (79.8%). As with the combination of any three examinations, LCT+hTERC gene+C-MYC gene got the highest Youden index(0.315) and the coincidence rate(51.0%). According tohistology, the rate of genomic amplification of TERC gene and C-MYC gene in high-grade cervicallesions group (52.%,47.6%) were higher than those in low-grade cervical lesions group (10.8%,10.2%). According to LCT, the rate of genomic amplification of TERC gene and C-MYC gene inLSIL/HSIL group (39.1%，30.4%) were higher than those in NILM/ASCUS group (13.6%，14.2%).Conclusion:1.The combination of LCT and HPV is highly-sensitive in the screening of cervicalcancer and can be carried out as primary screening method.2. The combination of amplification of TERC gene and C-MYC gene (FISH) ishighly-specific and can be used to help diagnosing high-grade cervical lesion.3. The rate of positive amplification of hTERC gene and C-MYC gene is closelycorrelated with the severity of cytological and histological cervical lesions..