Study On The Application Value Of HTERC Gene Detection Combined With TCT And High-Risk HPV E6/E7 MRNA Detection In Cervical Cancer Screening

Cervical cancer is the most common malignant tumor of the female reproductive system,and persistent high-risk HPV infection is the most common cause[1].Statistics in 2018 show that worldwide,the incidence and mortality of cervical cancer ranks fourth among female malignancies[2]The key to reducing the incidence and mortality of cervical cancer is the early detection of precancerous lesions.At present,combined screening of cytology and HPV is used as a screening strategy for cervical cancer in China.High,therefore,more effective detection methods are needed to improve this situation.Some studies have found that the rate of hTERC(human telomerase RNA component)gene amplification increases with the level of cervical lesions[3].In this study,the hTERC gene was detected in cervical exfoliated cells,and its application value in cervical cancer screening was explored in order to provide new ideas for cervical cancer screening.Objective:In this study,the hTERC gene amplification in cervical exfoliated cells was detected,and the relationship between hTERC gene amplification and cervical lesions was statistically analyzed to explore its application value in cervical cancer screening.Materials and Methods:107 cases of cervical exfoliated cells were collected from the Department of Pathology,Third Affiliated Hospital of Zhengzhou University.And hTERC gene amplification was detected by fluorescence in situ hybridization(FISH).The TCT results,high-risk HPV E6/E7 mRNA test results,and cervical histopathological results were collected from the specimen source patients.The pathological results were used as the gold standard.To analyze the sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of the three detection methods for the diagnosis of cervical lesions using statistical software.To analyze the sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of TCT and high-risk HPV E6/E7 mRNA co-test,hTERC gene,TCT and high-risk HPV E6/E7 mRNA co-test for the diagnosis of cervical lesions.Statistical software was used to make receiver operating characteristic(ROC)curves for hTERC gene detection,TCT and high-risk HPV E6/E7 mRNA detection for the diagnosis of high-grade cervical squamous intraepithelial lesions and cervical cancer.Results:1.The hTERC gene amplification rate increases with the level of cervical lesions increases(?2=50.93,P=0.028).The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of hTERC gene detection for cervical lesions are 62.03%,92.86%,96.08%,46.43%,0.55.2.The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of TCT for cervical lesions are 78.48%,75.00%,89.86%,55.26%,0.53.3.The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of high-risk HPV E6/E7 mRNA test for cervical lesions are 60.71%,86.75%,70.83%,0.52.4.Parallel experiment:The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of TCT and high-risk HPV E6/E7 mRNA co-test for cervical lesions are 97.47%,50.00%,84.62%,87.50%,0.45.The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of hTERC gene,TCT and high-risk HPV E6/E7 mRNA co-test are 98.70%,46.43%,83.87%,92.86%,0.45.5.Sequence test:The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of TCT and high-risk HPV E6/E7 mRNA co-test for cervical lesions are 72.15%,85.71%,93.44%,52.17%,0.58.The sensitivity,specificity,positive predictive value,negative predictive value,and Jordan index of hTERC gene,TCT and high-risk HPV E6/E7 mRNA co-test are 46.84%,100.00%,100.00%,40.00%,0.47.6.For the diagnosis of high-grade cervical squamous intraepithelial lesions and above,the area under the ROC curve(AUC)of hTERC gene detection,TCT,and high-risk HPV E6/E7 mRNA detection were 0.919,0.655,and 0.606,respectively.Pairwise comparison:The difference between hTERC gene detection and TCT was statistically significant(Z=5.32,P<0.001);the difference between hTERC gene detection and high-risk HPV E6/E7 mRNA detection was statistically significant(Z=8.11,P<0.001);There was no significant difference in TCT and high-risk HPV E6/E7 mRNA detection(Z=0.99,P=0.32).Conclusion:1.hTERC gene amplification can be a good indicator for predicting the degree of cervical lesions.2.hTERC gene test can be used as an effective supplementary method for traditional cervical cancer screening program(TCT combined with HPV test).