Reesink-Peters N, Helder M N, Wisman G B A, Knol A J, Koopmans S, Boezen H M, Schuuring E, Hollema H, de Vries E G E, de Jong S, van der Zee A G J
Department of Gynaecological Oncology, University Hospital Groningen, 9700 RB, Groningen, The Netherlands.
J Clin Pathol. 2003 Jan;56(1):31-5. doi: 10.1136/jcp.56.1.31.
To examine whether the detection of either telomerase and its components or high risk human papillomavirus (HPV) are of value in predicting the presence of cervical intraepithelial neoplasia (CIN) grade II/III in women referred because of cervical cytology reports showing at most moderate dyskaryosis.
Cervical scrapings of 50 women referred with cytological borderline, mild, or moderate dyskaryosis were analysed. Telomerase activity was assessed by a commercially available telomere repeat amplification protocol assay and its components human telomerase RNA (hTR) and human telomerase reverse transcriptase (hTERT) were assessed by reverse transcriptase polymerase chain reaction (PCR). HPV was detected by GP5+/6+ PCR enzyme immunosassay. Histological findings on colposcopy guided biopsies or excised cervical tissue were regarded as the final pathological diagnosis. The sensitivity and specificity for detecting CIN II/III were calculated.
Twenty eight women were diagnosed with CIN II/III. Telomerase activity was detected in none, hTR in 88%, hTERT in 23%, and high risk HPV was detected in 79% of these women. As a diagnostic test none of the described analyses combined a sensitivity of at least 90% with a specificity >or= 90%. Despite the small numbers, calculation of the 95% confidence intervals excluded a combined sensitivity and specificity of at least 90% for all of the evaluated parameters.
Neither detection of telomerase or its components, nor detection of high risk HPV seem suitable for the triage of women with borderline, mild, and moderate cytological dyskaryosis.
探讨检测端粒酶及其组分或高危型人乳头瘤病毒（HPV）对于预测因宫颈细胞学报告显示至多为中度核异质而转诊的女性是否存在宫颈上皮内瘤变（CIN）II/III级具有价值。
对50例因细胞学检查结果为临界、轻度或中度核异质而转诊的女性的宫颈刮片进行分析。采用市售的端粒重复序列扩增法检测端粒酶活性，通过逆转录聚合酶链反应（PCR）检测其组分人端粒酶RNA（hTR）和人端粒酶逆转录酶（hTERT）。采用GP5+/6+ PCR酶免疫分析法检测HPV。阴道镜引导下活检或切除的宫颈组织的组织学检查结果被视为最终病理诊断。计算检测CIN II/III的敏感性和特异性。
28例女性被诊断为CIN II/III。这些女性中，无一例检测到端粒酶活性，88%检测到hTR，23%检测到hTERT，79%检测到高危型HPV。作为诊断试验，所描述的分析均未将至少90%的敏感性与≥90%的特异性相结合。尽管样本量较小，但计算95%置信区间排除了所有评估参数具有至少90%的联合敏感性和特异性。
检测端粒酶或其组分以及检测高危型HPV似乎均不适用于对细胞学检查结果为临界、轻度和中度核异质的女性进行分流。
