Clinical Significance of Human Telomerase RNA Gene (hTERC) Amplification in Cervical Squamous Cell Lesions Detected by Fluorescence in Situ Hybridization

Background: Genomic amplification of the human telomerase RNA gene (hTERC), located in thechromosome 3q26 region, has been documented in tumorigenesis. The present study was designed to detecthTERC amplification in cervical lesions and evaluate whether this might serve as a supportive biomarkerto cytopathology or histopathology in the diagnosis of cervical lesions.
Methods: Liquid-based thin-layercytopathologic examination and detection of amplification by fluorescence in situ hybridization (FISH) wasconducted in 130 women, along with assessment of human papillomavirus DNA, colposcopy with biopsy, andhistopathologic examination.
Results: In cytopathologic examinations, hTERC amplification rates for negativefor intraepithelial lesion or malignancy (NILM),atypical squamous cells of undetermined significance (ASCUS),low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL) andsquamous cell carcinoma (SCC) cases were 0% (0/10), 4% (1/25), 20% (6/30), 77% (27/35), and 100% (10/10),respectively. The difference among abnormal cellular change groups was statistically significant (P<0.05). Inhistopathologic examinations, hTERC amplification rates in normal squamous cell with or without inflammatory,cervical intraepithelial neoplasia 1 (CIN 1), CIN 2, CIN 3 and SCC cases were 3.8% (2/52), 18.2% (6/33), 66.7%(6/9), 84.6% (22/26), 100% (10/10), respectively. There were significant differences among CIN1, CIN2, CIN3and SCC cases (P<0.05). The hTERC amplification was more specific than HPV positivity in differentiating lowgradefrom high-grade cervical disorders (specificity: 88.5% vs. 70.8%, P<0.05).
Conclusions: FISH detectionof hTERC amplification could be an effective adjunct to cytopathologic or histopathologic examination fordifferential diagnosis of low- and high-grade cervical squamous cell disorders.