TERC combined with high-risk HPV test for screening and triage of cervical low-grade intraepithelial lesions
Objective:To study the significance of combined application of telomerase RNA component(TERC)and high-risk human papillomavirus(HPV)in the screening and triage of cervical squamous intraepithelial lesions.Methods:The age,cervical fluid-based cytological diagnosis,high-risk HPV and histopathological findings were collected.The amplification status of TERC gene was detected by fluorescence in situ hybridization(FISH).The relationship between TERC and cytology,high-risk HPV,histopathology were comprehensively analyzed.Results:In the groups of 184 cervical cytology specrmens,the difference was statistically significant in TERC amplification analysis between atypical squamous cells of undetermined significance(ASCUS)and atypical aquamous cells,cannot exclude HSIL(ASC-H),and between ASCUS and high-grade squamous intraepithelial lesion(HSIL)cases;the difference in TERC analysis between low-grade squamous intraepithelial lesion(LSIL)and HSIL cases was statistically significant.In 92 cervical biopsy specimens,there were significant differences in TERC analysis between normal mucosa and cervical intraepithelial lesion grade 2(CIN2),CIN3,and between CIN1 and CIN2,CIN3.The sensitivity of high-risk HPV detection to HSIL was the highest,followed by TERC analysis,and the cytological sensitivity was the lowest,and there was a statistically significant difference between the former two and the latter.However,the specificity of cytological diagnosis was the highest,while that of high-risk HPV was the lowest,and the specificity differences among the three were statistically significant.TERC had the highest negative predictive value for HSIL.In 34 cases of ASCUS and 40 cases of LSIL,the specificity of TERC combined with high-risk HPV was the highest compared with that of single TERC analysis and high-risk HPV.Conclusion:TERC analysis can further assist distinguishing LSIL and HSIL.In the face of women with high-risk HPV infection,combined application of TERC analysis can assist in screening and triaging the outcome of low-grade cervical intraepithelial lesions,and further triage low-risk and high-risk groups,so as to achieve accurate referral and triage of colposcopy and improve personalized screening.Further more,the innovative TERC analysis combined with high-risk HPV,cervical liquid-based cytology screening was expounded to facilitate the clinical management of high-grade cervical intraepithelial lesions accurate shunting,and to complete personalized screening more efficiently.
万方数据
