Significance of human telomerase RNA gene amplification detection for cervical cancer screening.
OBJECTIVE
Liquid-based cytology is the most often used method for cervical cancer screening, but it is relatively insensitive and frequently gives equivocal results. Used as a complementary procedure, the high-risk human papillomavirus (HPV) DNA test is highly sensitive but not very specific. The human telomerase RNA gene (TERC) is the most often amplified oncogene that is observed in cervical precancerous lesions. We assessed genomic amplification of TERC in liquid-based cytological specimens to explore the optimal strategy of using this for cervical cancer screening.


METHODS
Six hundred and seventy-one residual cytological specimens were obtained from outpatients aged 25 to 64 years. The specimens were evaluated by the Digene Hybrid Capture 2 (HC2) HPV DNA test and fluorescence in situ hybridization (FISH) with a chromosome probe to TERC (3q26). Colposcopic examination and histological evaluation were performed where indicated.


RESULTS
The TERC positive rate was higher in the CIN2+ (CIN2, CIN3 and SCC) group than in the normal and CIN 1 groups (90.0% vs. 10.4%, p<0.01). In comparison with the HC2 HPV DNA test, the TERC amplification test had lower sensitivity but higher specificity (90.0% vs. 100.0%, 89.6% vs. 44.0%, respectively). TERC amplification test used in conjunction with the HC2 HPV DNA test showed a combination of 90.0% sensitivity and 92.2% specificity.


CONCLUSIONS
The TERC amplification test can be used to diagnose cervical precancerous lesions. TERC and HPV DNA co-testing shows an optimal combination of sensitivity and specificity for cervical cancer screening.
Department of Obstetrics and Gynecology, Weifang People's Hospital, Weifang, China E-mail : zhangyouzhong@sdu.edu.cn.
Shao-Min
SM
Chen
Wei
W
Lin
Xin
X
Liu
You-Zhong
YZ
Zhang
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000235:genetics / Q000821:virology; D002584:Cervix Uteri / Q000378:metabolism / Q000821:virology; D003581:Cytodiagnosis; D055088:Early Detection of Cancer; D005260:Female; D005784:Gene Amplification; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012313:RNA; D062085:RNA, Long Noncoding / Q000235:genetics*; D012307:Risk Factors; D019098:Telomerase / Q000235:genetics*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000235:genetics / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000821:virology
D062085:RNA, Long Noncoding; C422952:telomerase RNA; D012313:RNA; C509186:TERT protein, human; D019098:Telomerase