Study Of Values Of Combined Detection Of Liquid Based Cytology,HPV,hTERC And C-MYC Oncogene In Screeningof Cervical Cancer

[Background] Cervical cancer is most common woman genital system malignanttumor. Although the incidence of cervical cancer has decreased notably, but each year,there are about131,500new cases of cervical cancer in our country, that is28.8percent of new cases of cervical cancer around the world, and showing youngtendency. For sake of cutting down the incidence and mortality of cervical cancer,early and accurate screen precancerous lesion before cervical cancerit is critical.Currently,the screening of cervical cancer in clinical primarily by liquid-based cytology(TCT), HPV testing and colposcopy,colposcopy is one of invasived examination. Thesensitivity of TCT is lowe, the sensitivity of HPV testing is high, but its spcificity islow, so it is an urgent thing to found other reliable indicators or tools toassist the above detection to comprehensive judgments, that can make cervical cancerearly screening more accurate, more reliable and more predictable. In recentyears,there many reports about detecting the expression of the hTERC and C-MYConcogene in uterine cervix by FISH,but it is still a lack of correlation research aboutTCT,HPV testing, hTERC and C-MYCgeneamplification detected in precancerouscervical lesions and cervical cancer screening. The purpose of this study is to explorethe efficiency,advantages and disadvantages about the four indexes in cervical cancerscreening.We hope to provide a basis to improve the sensitivity, specificity andaccuracy of cervical cancer screening,and simplify the screening process and program.[Objective]By comparing TCT,HPV testing, hTERC and C-MYC gene amplification deteced to clinical pathology results and point out the best solutioto improve thecervical cancer early diagnosis of sensitivity, specificity and accuracy.[Methods]1)Use TCT analysis cervix exfoliated of chronic cervicitis, CIN I, CIN II/III andcervicalcancer patients,cytology results are described according to TBS system.2）Use HCⅡ hybrid capture detection kit to investigate the HR-HPV DNA in cervixexfoliated cells of chronic cervicitis,CIN I, CIN II/III and cervical cancer patients.3）Use the fluorescent in situ hybridization(FISH) to detect the the expression ofhTERCand C-MYC oncogene in cervix exfoliated cells of chronic cervicitis,CIN I,CIN II/III and cervical cancer patients.[Results]（1）Pathology results as the gold standard to separate analysis the sensitivity,specificity and accuracy of these four test results， the result showed that the highestsensitivity for HPVtesting (85.5%),followedby the hTERC gene detection (85.1%), thehighest specificity for hTERC and C-MYC gene testing (88.8%), the highest accuracyfor hTERC genetic testing (86.4%).（2）Any two indexes combination, any index positive for positive, pathological resultsas the gold standard analysis the sensitivity, specificity and accuracy of theseresults， the result showed that the highest sensitivity for TCT+HPV（87.8%）andhTERC+HPV(87.8%),the highest specificity for hTERC+C-MYC gene testing (87.5%),the highest accuracy also for hTERC+C-MYCgenetic testing（86.4%）.（3）Any three indexes combination, any index positive for positive, pathologicalresults as the gold standard analysis the sensitivity, specificity and accuracy of theseresults, the result showed that the highest sensitivity forTCT+HPV+hTERC.（97.9%）,the highest specificity for hTERC+C-MYC+TCT testing (80.2%), the highestaccuracy also for TCT+HPV+hTERC gene testing（89.9%）.（4）Four indexes combination, any index positive for positive, pathological results as the gold standard analysis the sensitivity, specificity and accuracy of theseresults， the result showed that the sensitivity is97.9%,the specificity is70%, theaccuracy is88.1%.[Conclusion]HPV detection and FISH for hTERC gene testing in CIN II/III and cervicalcancer detection havehighsensitivity, highspecificity,then they form a complementarywith TCT, there is a high value for TCT HPV,hTERC combined detection of cervicalcancer and cancerprecancerous lesions screening. C-MYC gene amplification increasedwith the serious degree of pathological grade. C-MYC gene can act as a molecular markin cervical cancer and cancerprecancerous lesions screening.