The Expressions Of HTERC Gene And C-MYC Gene In Cervical Cytology Samples And The Clinical Research

Objective:To study the expressions of the human telomerase RNA (hTERC) gene and the C-MYC gene in cervical cytology samples, and the results of the liquid based cytology, TERC gene and C-MYC gene tests were compared with the histopathology in sensitivity and specificity.The aim of this study is to evaluate the clinical value of the three tests in detection of cervical cancer and precancerous lesions.Methods:249 women were examined with liquid-based cytology, hTERC gene detection and C-MYC gene detection using fluorescence in situ hybridization (FISH) in Nanjing Hospital during September 2010 to January 2012. Every patient was examined by colposcopy, multiple biopsies of cervical quadrant and pathology. We used SPSS 19.0 to break down the relationship between the increase of hTERC gene and C-MYC gene expressions and the severity of cervical intraepithelial neoplasia. Analyze the sensitivity and specificity of hTERC gene and C-MYC gene detection alone or combination, and evaluate the diagnostic value of different indicators in cervical lesions.Results:1、hTERC gene-positive rate tended to increase with the progress of cervical lesions, and the hTERC gene positive rate in group>CIN2 is higher than group≥ CIN1 in the histopathologic results, the difference has statistically significant.(Χ2=112.686, P<0.00)2、C-MYC gene-positive rate tended to increase with the progress of cervical lesions, and the hTERC gene positive rate in group>CIN2 is higher than group≤ CIN1 in the histopathologic results, the difference has statistically significant.(Χ2=62.916, P<0.00)3、hTERC gene and C-MYC gene detection in the diagnosis of the value of the high-level cervical lesions:(1) The hTERC C-MYC gene Independent testing:Taking positive cells> 5.12% as the boundary point, the sensitivity of hTERC gene in group≥ CIN2 is higher than the C-MYC gene in FISH testing,While, specificity was slightly lower than the C-MYC gene. The Youden index of hTERC gene detection was significantly higher than the C-MYC gene, also higher than the liquid-based cytology test.(2) Combine hTERC with C-MYC gene:Taking positive cells> 5.12% as the boundary point, the sensitivity in group≥ CIN2 is 91.7%. Specificity degree is 83.6%. The Youden index is 0.753. The positive predictive value is 69.5%. The negative predictive value is 96.1%. Conclusions:1、The amplification of hTERC gene in cervical intraepithelial neoplasia is increased with the serious degree of cytology and histopathologic grades.2、The amplification of C-MYC gene in cervical intraepithelial neoplasia is increased with the serious degree of cytology and histopathologic grades.3、The sensitivity of separate hTERC gene detection diagnostic are higher than the C-MYC gene detection and liquid-based cytology testing. The specificity of the C-MYC gene detection is higher than both liquid-based cytology testing and hTERC gene detection. The specificity of the hTERC gene detection is higher than liquid-based cytology testing. The accuracy of the hTERC gene detection is the highest of the three indexes.4、The accuracy of joint genetic testing diagnostic is higher than any single genetic testing. hTERC gene combined with C-MYC gene detection applied to be the basis of the further processing in cervical cancer screening result. Meanwhile, they has an important significance in early diagnosing of cervical lesions and guiding clinical treatment.