title: Detection of TERC amplification in cervical epithelial cells for the diagnosis of high-grade cervical lesions and invasive cancer: a multicenter study in China.
abstract: Because the activation of telomerase is a relatively early event in the progression of cervical carcinogenesis, the expression of the human telomerase RNA gene, TERC, has the potential to serve as a biomarker for both the diagnosis and prognosis of cervical neoplasias. In total, 83 research centers participated in the study, and 7786 patients were enrolled. TERC amplification was detected using a dual-color fluorescence in situ hybridization (FISH) probe set, and these results were compared with cytological and histological results, testing for high-risk human papillomavirus (HPV) DNA (n = 2316 for the HPV DNA test), as well as patient age. TERC amplification was found to be increased in more advanced cases of cervical carcinogenesis. Moreover, a Youden's index value and the area under the receiver operating characteristic (ROC) curve were also calculated for samples with TERC amplification and found to be higher than the same values calculated for both cytology and high-risk HPV analyses of the same samples. With regard to cytological ASCUS and LSIL findings, the combination of HPV + TERC testing showed the potential to provide effective triaging to detect CIN2(+). Therefore, TERC amplification represents a valuable genetic biomarker, which in combination with an evaluation of cytology or HPV testing, can achieve higher sensitivity and specificity in distinguishing high-grade cervical lesions and invasive cancers from low-grade lesions compared with conventional methods.
authors.affiliation: Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Jiang
authors.forename: Li-Hui
authors.initials: LH
authors.lastname: Wei
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Li
authors.forename: Rui-Fang
authors.initials: RF
authors.lastname: Wu
authors.forename: Xing
authors.initials: X
authors.lastname: Xie
authors.forename: You-Ji
authors.initials: YJ
authors.lastname: Feng
authors.forename: Guo
authors.initials: G
authors.lastname: Zhang
authors.forename: Chao
authors.initials: C
authors.lastname: Zhao
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhao
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002584:Cervix Uteri / Q000166:cytology / Q000473:pathology / Q000502:physiology; D002681:China; D004847:Epithelial Cells / Q000166:cytology / Q000473:pathology / Q000502:physiology; D005260:Female; D005784:Gene Amplification; D006801:Humans; D017404:In Situ Hybridization, Fluorescence / Q000379:methods; D008875:Middle Aged; D012313:RNA / Q000235:genetics*; D012680:Sensitivity and Specificity; D019098:Telomerase / Q000235:genetics*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000235:genetics / Q000473:pathology
chemical_list: C422952:telomerase RNA; D012313:RNA; D019098:Telomerase