Objective: To study the amplification of human telomerase RNA component (hTERC) gene in the cervical exfoliated cells from natural population in Shenzhen and to explore its relationship with human pappiloma-virus (HPV) infection, abnormal cervical cytology and cervical intraepithelial neoplasia (CIN).
Methods: Three hundred and eighty-eight women, 30 - 59 year-old and having normal intelligence in a community of Shenzhen, were examined with liquid-based cytology. Human pappiloma-virus (HR-HPV) was tested by hybrid capture II (HC-II) and hTERC gene detection by fluorescence in situ hybridization (FISH). Patients with ASCUS and above lesion, and/or positive HR-HPV results and/or amplification of hTERC gene were examined by colposcopy, multiple biopsies of cervical quadrant and pathology.
Results: The frequencies of CIN I, II, III, cervical cancer were 55 (14.18%), 4 (1.03%), 9 (2.32%) and 1 (0.26%) respectively, with the rate of hTERC gene amplification as 8.76%. There were significantly differences of hTERC amplification among the samples with different cytological and histological lesions as well with HPV infection (P < 0.01). (1) The positive rate of HPV infection was 17.01%; the positive rates of hTERC gene amplification were 19.70% in HPV positive and 6.52% in HPV negative samples and the results were significantly different (P < 0.01). (2) Cytologically, the rates of hTERC gene amplification appeared to be as follows: NILM (5.97%), ASCUS (18.75%), LSIL (10.00%), ASC-H (66.67%), HSIL (100.00%). There was a marked increase of hTERC amplification in patients with HSIL and above lesions (P < 0.01). (3) On histology findings, the rates of hTERC gene amplification were as follows: NILM (0%), CIN I (5.45%), CIN II (50.00%), CIN III (77.78%), and invasive carcinoma (100.00%). There was a marked increase of hTERC amplification in patients with CIN II and above lesions (P < 0.01).
Conclusion: There was a close correlation between amplification of hTERC and histological as well cytological lesions which increased progressively along with the severity of cytological and histological grade. The evidence of hTERC, with or without amplification, might serve as a prognostic indicator to measure the grade of lesion.