Detection of human telomerase RNA gene in cervical cancer and precancerous lesions: comparison with cytological and human papillomavirus DNA test findings.

OBJECTIVES: The aims of this study were to compare the findings of fluorescence in situ hybridization (FISH) detection of human telomerase RNA gene (hTERC) amplification with that of cytological and human papillomavirus (HPV) DNA tests and explore the possibility to improve the accuracy of the diagnoses of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer.

METHODS: A total of 201 specimens of liquid-based thin-layer cytological examination findings were collected and detected by HPV DNA test and hTERC detected by FISH. All women underwent colposcopy and histological examination of biopsy specimen if needed. The 3 screening methods were compared based on histological examination of colposcopic biopsies.

RESULTS: The amplification of hTERC showed 6.06% in normal or inflammation cases, 10.00% in CIN 1, 66.67% in CIN 2, 72.50% in CIN 3, and 100.00% in carcinoma, with significant difference between the low- (<or=CIN 1 or <or=low-grade squamous intraepithelial lesion) and high-grade (>or=CIN 2 or >or=atypical squamous cells in which high-grade squamous intraepithelial lesion cannot be excluded) cervical lesions (P < 0.001). The hTERC amplification rate was consistent with abnormal rates of cytological and histological diagnoses. The detection of hTERC amplification had a much higher accuracy (87.56%) than the cytological (80.10%) and HPV DNA test (77.61%) findings.

CONCLUSIONS: Using FISH to detect the amplification of hTERC had a much higher specificity and accuracy for the diagnoses of high-grade CIN and cervical cancer than cytological and HPV DNA test findings, suggesting that this detection might be a useful and specific screening method in cervical cancer and precancerous lesions.