Significance of human telomerase RNA gene amplification detection for cervical cancer screening

Aim: Liquid-based cytology is the most often used method for cervical cancer screening, but it is relativelyinsensitive and frequently gives equivocal results. Used as a complementary procedure, the high-risk humanpapillomavirus (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 genomicamplification of TERC in liquid-based cytological specimens to explore the optimal strategy of using this forcervical cancer screening. Methods: Six hundred and seventy-one residual cytological specimens were obtainedfrom outpatients aged 25 to 64 years. The specimens were evaluated by the Digene Hybrid Capture 2 (HC2) HPVDNA test and fluorescence in situ hybridization (FISH) with a chromosome probe to TERC (3q26). Colposcopicexamination and histological evaluation were performed where indicated. Results: The TERC positive rate washigher 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 higherspecificity (90.0% vs. 100.0%, 89.6% vs. 44.0%, respectively). TERC amplification test used in conjunctionwith the HC2 HPV DNA test showed a combination of 90.0% sensitivity and 92.2% specificity. Conclusion: TheTERC amplification test can be used to diagnose cervical precancerous lesions. TERC and HPV DNA co-testingshows an optimal combination of sensitivity and specificity for cervical cancer screening.