The Application Value Of Thin Prep Cytologic Test(TCT)、Human Papillomavirus(HPV)DNA、Human Telomerase RNA Component (hTERC)Gene Combined Detection In Screening For Cervical Cancer

Background and ObjectiveInvasive Cervical Cancer (ICC) is the one of malignant tumors which threated to women’s health seriously; the incidence is the head of the reproductive tract malignant tumor in women, the mortality in malignant tumor in all women coming in second place behind breast Cancer. However, the occurrence of cervical cancer development can prevent and control. The key is early detection, early diagnosis and early treatment with cervical intraepithelial neoplasias (CIN). In recently years, women cervical cancer screening developing quickly in our country, the prognosis of cervical cancer significantly improved, however,every year there are still about 130000new cases. Therefore, the key is how to further expand the screening scope, improving the sensitivity of the screening, specificity, making an optimization scheme. At present, Thin-Prep Cytology test(TCT) and human papillomavirus(HPV)DNA detection is common using for cervical cancer screening. As the breakthroughs of molecular pathology, human telomerase RNA component (hTERC) gene detection was gradually used in the clinical. At present, there are few reports about TCT HPV-DNA detection and hTERC genetic detection applied in cervical cancer screening. This paper takes pathology diagnosis as gold standard, to evaluate the application of Thin-Prep Cytology test(TCT)、human papillomavirus(HPV)DNA、 human telomerase RNA component (hTERC) gene combined detection in cervical cancer screening.Materials and methods1The tissuesThe1000cases of the biopsy specimen were chosen from Henan Province People’s Hospital outpatients from December2010to March2011. Inclusion criteria: Whose age were from25to64years, no pregnancy and breast-feeding and menstrual period; no cervical biopsy and operation, no CIN, no hysterectomy and reproductive system malignancies disease histories. All the enshrines are informed agreement signed.2Methods2.1MaterialsUsing sterile dry tampon gently wiped the secretion of the surface, to take cells from cervical transitional belt were used conventional methods of TCT, and washing cells into liquid which kept in a small bottle for preservation.2.2Methods one sample had TCL、HPV-DNA(SPR method)、hTERC detection (fluorescence in situ hybridization FISH technique) respectively, for screening for cervical carcinoma, the specimen whose any result of the three kinds of detection methods was positive will undergo colposcopy and cervical biopsy. Based on the histopathology as the gold standard, to evaluate the sensitivity, specificity, Youden index and the coincidence rate of the three methods in cervical screening.2.3Statistical analysisAll the data was computed by SPSS13.0statistics software. The sensitivity, specificity, Youden index and the coincidence rate of the three methods were calculated. The correlation of detection rate and the pathologic result were analysised by chi-square test. The criterion for statistical significance was α=0.05.Results1000cases of patients, average age is41±9years, TCT abnormal results were119cases, accounting for11.9%; HPV-positive136cases, accounting for13.6%; hTERC gene amplification in a total of58positive cases, accounting for5.8%. Colposcopy and cervical biopsy routine229, in which cervical intraepithelial neoplasia (CIN) of36cases, including CIN1:13patients (5.68%), CIN2:13patients (5.68%), CIN3:8patients (3.49%), SCC2cases (0.87%).Single application of a screening program, TCT has highest sensitivity (83.3%). Application of any two programs combined screening, TCT+HPV has highest sensitivity (94.4%), but the lowest specificity (29.6%); TCT or HPV testing combined with hTERC gene, can make both higher sensitivity and specificity.The positive rate of hTERC amplification was higher in high-risk HPV positive patients (27.5%)than in high-risk HPV negative patients(2.8%,P=0.00),all of hTERC amplification with high-risk HPV-positive patients,81.8%were CIN or cervical cancer sufferers.With the increased level of pathology, the detection rate of the screening program was gradually increased, P<0.05.In all ASC-US sufferers, the detection rate of higher degree(>CIN2) whose result of hTERC is positive is higher than whose result is negative (χ2=4.980, P<0.05). Conclusion1. HPV-DNA+hTERC combined screening of genetic testing is the best way to detect cervical cancer and precancerous lesions.2. hTERC gene and HPV-DNA detection were both positive have high coincidence rate to diagnose CIN and cervical cancer.3. hTERC gene detection could be regarded as a method of the stratified management for ASC-US sufferers,which can forecast the degree of the cervical diseases as early as possible.