Ji Wenting, Lou Weihua, Hong Zubei, Qiu Lihua, Di Wen
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, P.R. China.
Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, P.R. China.
Oncol Lett. 2019 Feb;17(2):2099-2106. doi: 10.3892/ol.2018.9825. Epub 2018 Dec 12.
Cervical cancer is one of the most prevalent female cancer types in developing countries. ThinPrep cytological test (TCT) and human papillomavirus (HPV) detection are canonical screening methods for cervical cancer currently. However, there are limitations to these techniques. The aim of the present study was to identify efficient and practical methods for the screening of cervical intraepithelial neoplasia (CIN) and carcinoma. Residual PreservCyt specimens were obtained from 1,000 women who were admitted between August 2013 and December 2015. TCT, human telomerase RNA component (h-TERC) fluorescent hybridization (FISH), MYC-specific FISH and surface plasmon resonance (SPR)-HPV genotyping were performed, followed by histopathology for those patients with positive results in any of the four tests. As a result, 106, 64, 56 and 112 patients were positive in the TCT, h-TERC, c-MYC and SPR-HPV tests, respectively, resulting in 213 being scheduled for histopathology; inflammation was identified in 159 patients, CIN I in 31, CIN II in 14, CIN III in seven and invasive cervical cancer in two patients. Using histopathology as the gold standard, TCT exhibited the highest sensitivity (87.04%), while h-TERC analysis had the highest specificity (81.76%). Parallel tests demonstrated that the Youden's index of TCT + h-TERC was the highest (0.49), while the serial analysis reported that TCT + HPV had the highest Youden's index (0.53) compared with any of the biomarkers alone (TCT, 0.50; HPV, 0.29; h-TERC, 0.47). In conclusion, dual positive TCT and HPV may be an efficient approach for basic screening of cervical lesions. h-TERC amplification may serve as an auxiliary test to improve the specificity.
宫颈癌是发展中国家最常见的女性癌症类型之一。薄层液基细胞学检测（TCT）和人乳头瘤病毒（HPV）检测是目前宫颈癌的标准筛查方法。然而，这些技术存在局限性。本研究的目的是确定筛查宫颈上皮内瘤变（CIN）和癌的有效实用方法。从2013年8月至2015年12月入院的1000名女性中获取剩余的PreservCyt标本。进行TCT、人端粒酶RNA组分（h-TERC）荧光杂交（FISH）、MYC特异性FISH和表面等离子体共振（SPR）-HPV基因分型，然后对这四项检测中任何一项结果为阳性的患者进行组织病理学检查。结果，TCT、h-TERC、c-MYC和SPR-HPV检测分别有106、64、56和112例患者呈阳性，导致213例患者接受组织病理学检查；159例患者被诊断为炎症，31例为CIN I，14例为CIN II，7例为CIN III，2例为浸润性宫颈癌。以组织病理学为金标准，TCT的敏感性最高（87.04%），而h-TERC分析的特异性最高（81.76%）。平行检测显示TCT + h-TERC的约登指数最高（0.49），而系列分析表明TCT + HPV的约登指数最高（0.53），高于任何单一生物标志物（TCT，0.50；HPV，0.29；h-TERC，0.47）。总之，TCT和HPV双阳性可能是宫颈病变基础筛查的有效方法。h-TERC扩增可作为辅助检测以提高特异性。
