Detection Of Hterc And Hpv In Liquid Cervical Cytology Specimen As A Combined Test For The Screening Of Cervical Cancer

Objective:To investigate the clinical significance of genomic amplification of the telomerase RNA component (hTERC) gene serving as a genetic biomarker combined with HPV testing and Thinprep Cytologic Test in the screening of cervical cancer.Methods:a total of1000cases were enrolled and examined with liquid-based cytology (TCT), human papillomavirus testing based on the technology of surface plasmon resonance (SPR) and hTERC gene detection using fluorescence in situ hybridization (FISH).The patients with positive result(≥ASCUS for TCT, HR-HPV positive, genomic amplification of hTERC) of any of the three test methods underwent colposcopy,multiple biopsies of cervical quadrant and histological examination.Results:1.Genomic amplification of hTERC was detected in6.90%of the1000TCT specimens,1.88%of the NIML,19.14%of the ASCUS,51.85%of the LSIL,73.91%of the HSIL,100.00%of the SCCA, with higher proportion in cases with HSIL and higher grades than LSIL and lower grades (P<0.05).2.263cases were diagnosed by histological examination,6.79%of the cases with cervical inflammation were positive for hTERC amplification,27.27%of the CIN1,64.00%of the CIN2,90.48%of the CIN3,100%of the invasive cervical cancer(ICC),with statistically differences between one another except for CIN3and ICC(P<0.05), and the positive rate of hTERC amplification in CIN2and higher grade lesions is higher than CIN1and lower grade lesions (P<0.05); genomic amplification of hTERC was detected in28.05%of high-risk human papillomavirus (HR-HPV) positive cases, and2.80%in HR-HPV negative cases with significant difference (P<0.05)3.Infection with HR-HPV was detected in16.40%of all the specimens, with higher proportion in CIN2and higher grade lesions than CIN1and lower grade lesions (P<0.05), and was detected separately in66.67%and12.67%of cases with and without genomic amplification of hTERC,with significant difference (P<0.05).4.The sensitivity of hTERC amplification detection for the diagnosis of high grade cervical lesions (≥CIN2) and invasive cervical cancer is similar to that of TCT and HR-HPV testing (P>0.05), Both the specificity and the positive predictive value (PPV) of hTERC amplification detection are higher than those of HR-HPV testing and TCT (P<0.05), and the negative predictive value (NPV) of hTERC amplification detection is higher than that of HR-HPV testing (P<0.05), and similar to that of TCTConclusions:1.The positive rate of Genomic amplification of hTERC increases with the worsening of cervical lesions.2.Infection with HR-HPV and Genomic amplification of hTERC are strongly associated events.3.hTERC detection in combination with the evaluation of cytology or HPV testing can achieve higher accuracy compared with conventional methods.