title: Quantitative determination of human telomerase reverse transcriptase messenger RNA expression in premalignant cervical lesions and correlation with human papillomavirus load.
abstract: Expression of human telomerase reverse transcriptase (hTERT) messenger RNA (mRNA) and human papillomavirus (HPV)-16 load were quantified using real-time polymerase chain reaction and correlated with cytological findings and the presence of HPV infection in cervical specimens. Human telomerase reverse transcriptase mRNA expression was evaluated in 15 (20.5%) of 73 specimens of atypical squamous epithelial cells of undetermined significance, in 62 (39.7%) of 156 low-grade squamous intraepithelial lesions (LGSILs), in 49 (96%) of 51 high-grade squamous intraepithelial lesions (HGSILs), and in 9 (20%) of 45 normal samples, whereas viral load was quantified in 52 (89.6%) of 58 samples infected with HPV-16. The mean levels of hTERT mRNA expression were 0.11 in normal tissue, 0.23 in atypical squamous epithelial cells of undetermined significance, 0.75 in LGSILs, and 2.5 in HGSILs. Thus, a significant increase in hTERT mRNA expression was observed with increasing degrees of cervical dysplasia. The HPV-16 load was significantly higher in samples of HGSIL than in those of LGSILs (P < .001). A significant correlation was observed between viral load and quantitative hTERT mRNA expression (r = 0.65; P < .05). Quantitative hTERT mRNA assessment showed 96% sensitivity and 100% negative predictive value for high-grade dysplasia, whereas the specificity and positive predictive value were 72% and 36.2%, respectively. It is suggested that quantitative hTERT has a very high sensitivity and negative predictive value, whereas the observed specificity was moderate, indicating that it cannot be used as a diagnostic marker but may be an adjunct in the management of women with high-grade cervical dysplasia. However, the final diagnosis must rely on the inclusion of clinical evaluation and additional assessment data.
authors.affiliation: Department of Cytogenetics and Medical Genetics, University of Thessalia Medical School, Larissa, Greece.
authors.forename: Pagona
authors.initials: P
authors.lastname: Oikonomou
authors.forename: Iordanis
authors.initials: I
authors.lastname: Mademtzis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Messinis
authors.forename: Aspasia
authors.initials: A
authors.lastname: Tsezou
mesh_terms: D000328:Adult; D004268:DNA-Binding Proteins / Q000096:biosynthesis / Q000235:genetics*; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000201:enzymology* / Q000821:virology; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000201:enzymology* / Q000821:virology; D012333:RNA, Messenger / Q000378:metabolism*; D019098:Telomerase / Q000096:biosynthesis / Q000235:genetics*; D002583:Uterine Cervical Neoplasms / Q000201:enzymology* / Q000821:virology; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000201:enzymology* / Q000821:virology
chemical_list: D004268:DNA-Binding Proteins; D012333:RNA, Messenger; D019098:Telomerase