Detection of telomerase, its components, and human papillomavirus in cervical scrapings as a tool for triage in women with cervical dysplasia.
OBJECTIVE
To examine whether the detection of either telomerase and its components or high risk human papillomavirus (HPV) are of value in predicting the presence of cervical intraepithelial neoplasia (CIN) grade II/III in women referred because of cervical cytology reports showing at most moderate dyskaryosis.


METHODS
Cervical scrapings of 50 women referred with cytological borderline, mild, or moderate dyskaryosis were analysed. Telomerase activity was assessed by a commercially available telomere repeat amplification protocol assay and its components human telomerase RNA (hTR) and human telomerase reverse transcriptase (hTERT) were assessed by reverse transcriptase polymerase chain reaction (PCR). HPV was detected by GP5+/6+ PCR enzyme immunosassay. Histological findings on colposcopy guided biopsies or excised cervical tissue were regarded as the final pathological diagnosis. The sensitivity and specificity for detecting CIN II/III were calculated.


RESULTS
Twenty eight women were diagnosed with CIN II/III. Telomerase activity was detected in none, hTR in 88%, hTERT in 23%, and high risk HPV was detected in 79% of these women. As a diagnostic test none of the described analyses combined a sensitivity of at least 90% with a specificity >or= 90%. Despite the small numbers, calculation of the 95% confidence intervals excluded a combined sensitivity and specificity of at least 90% for all of the evaluated parameters.


CONCLUSIONS
Neither detection of telomerase or its components, nor detection of high risk HPV seem suitable for the triage of women with borderline, mild, and moderate cytological dyskaryosis.
Reesink-Peters
N
N
Department of Gynaecological Oncology, University Hospital Groningen, 9700 RB, Groningen, The Netherlands.
Helder
M N
MN
Wisman
G B A
GB
Knol
A J
AJ
Koopmans
S
S
Boezen
H M
HM
Schuuring
E
E
Hollema
H
H
de Vries
E G E
EG
de Jong
S
S
van der Zee
A G J
AG
D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D004268:DNA-Binding Proteins; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D011230:Precancerous Conditions / Q000201:enzymology / Q000821:virology; D011237:Predictive Value of Tests; D012313:RNA / Q000032:analysis; D012680:Sensitivity and Specificity; D019098:Telomerase / Q000032:analysis*; D014218:Triage / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000201:enzymology / Q000821:virology / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000821:virology; D014626:Vaginal Smears / Q000379:methods
D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C422952:telomerase RNA; D012313:RNA; D019098:Telomerase