Telomerase and the process of cervical carcinogenesis.

The integration of HPV infection in the epithelial cells is a key step in the induction of malignant changes of cervical cancer. In addition, there appear also other genomic alterations. Multi-step nature of carcinogenesis includes sequential accumulation of genetic changes that lead to invasive growth and progression. It is therefore necessary to understand the cervical carcinogenesis accompanied by chromosomal aberrations. The most common aberrations contain regions 5p15 and 3q26 coding the enzyme telomerase. For cervical cancer, telomerase is already active in case of precancerous lesions. Amplification of chromosomal region 3q26 detected by fluorescence in situ hybridization has the highest combined sensitivity and specificity in distinguishing low-grade lesion of high-grade lesions or invasive disease compared to the liquid-based cytology (LBC) and HPV DNA.