The Clinical Significance Of Human Papillomavirus、h-TERC、C-MYC Gene Detection In Cervical Cancer Screening

ObjctiveTo detect the abnormal expression of human cervical h-TERC gene, C-MYC gene and detect the human papillomavirus (HPV) infection, in order to investigate their clinical significance in cervical cancer screening.MethodsWe picked1000cases who came to the Second Xiangya Hospital of Central South University for cervical lesion screening or treatment from November2010to May2011as research objects. The cervical exfoliated cells were taken. People have to offer their thinprep cytology test results.Fluorescence In Situ Hybridization (FISH) was obtained to detect h-TERC, C-MYC gene, and Surface Plasmon Resonance (SPR) was used to detect HPV. If any of the indicators is positive, conventional colposcopy biopsy and histopathological examination were performed, and the pathological results were regarded as the golden standard. And the correlation between TCT, the h-TERC, the C-MYC, HPV and histopathological results.Results1.283out of1000cases were tested positive for any of the four indicators(TCT,h-TERC,C-MYC and HPV), were examed by colposcopy biopsy. According to the results of pathologic examination181cases were diagnosed as chronic cervicitis,39cases as CIN1,22cases as CIN2,21cases as CIN3, and20cases as cervical cancer.2.184cases were positive for HPV infection, and the total infection rate was18.4%(184/1000); among which161cases were infected with high risk HPV(including the single high-risk HPV and multiple high-risk HPV),17cases with low risk HPV(including the single low-risk type HPV and multiple low-risk type HPV),6cases with mixed HPV, which accounted for87.5%(161/184),9.24%(17/184),3.26%(6/184) of the entire HPV infection respectively. The positive rates for HR-HPV infection in different pathological grades were:CIN158.97%(23/39)、CIN286.36%(19/22). CIN390.48%(19/21) and cervical cancer100%(20/20), comparisons between the four groups are statistically significant (P<0.05). The sensitivity and specificity of the HR-HPV detection for cervical lesions was79.41%and43.09%respectively. The positive predictive value was44.02%, and the negative predictive value was78.78%.3. h-TERC gene abnormal amplification was found in70cases, and the total abnormal amplification rate was7%(70/1000), and the abnormal amplification rate for CIN1, CIN2, CIN3and cervical cancer were25.64%(10/39),50.0%(11/22),90.48%(19/21),and95%(19/20) respectively. The genetic abnormal amplification rate was significantly lower in CIN1and CIN2than that of CIN3and cervical cancer patients (P <0.05). There was no significant difference between CIN3and cervical cancer group (P>0.05). The sensitivity and specificity of h-TERC gene in the detection of cervical lesions was57.84%and93.92%respectively, and the positive predictive value was84.29%, and the negative predictive value was79.8%.4. C-MYC gene abnormal amplification was found in64patients, and the total abnormal amplification rate is6.4%(64/1000). the abnormal expression rate for CIN1, CIN2, CIN3and cervical cancer were20.51%(8/39),40.91%(9/22),85.71%(18/21) and90%(18/20) respectively, The difference between CIN1group and other groups(including CIN2, CIN3and cervical cancer group) was statistically significant (P<0.05); The difference between CIN3and cervical cancer group was not significant(P>0.05). The sensitivity and specificity of C-MYC gene in the detection of cervical lesions is51.96%and93.92%respectively.The positive predictive value is82.81%, and the negative predictive value is77.63%.5. HPV infection and h-TERC gene abnormal amplification were positively correlated(r=0.335, P=0.000), HPV infection and C-MYC gene abnormal amplification were positively correlated(r=0.308, P=0.000), h-TERC gene C-MYC gene abnormal amplification were positively correlated(r=0.857, P=0.000). 6. The sensitivity and specificity of combined tests(any one of the three tests including HPV, h-TERC and C-MYC with TCT) were higher than any single test. Of the combined tests HPV and TCT were best.Conclusion1. The detection sensitivity of HPV and TCT in cervical lesions is high, the detection specificity of h-TERC and C-MYC in cervical lesions is high, and any one of them can be used as an effective indicator in cervical cancer screening.2. Combined tests can improve the accuracy of cervical cancer screening, Of the combined tests HPV and TCT were best.