Diagnosis Value of Minichromosome Maintenance Protein 2 by Immunocytochemical Test on Cervical Lesions and Its Relationship With Human Papillomavirus Infection

Abstract

Objective To explore the expression and clinical significance of minichromosome maintenance protein 2 (MCM2) in cervical lesions and its relationship with human papillomavirus (HPV) infection. Methods From October 2011 to December 2012,a total of 183 cases of cervical lesions suffered from Thinprep liquid-based cytology test (TCT) and the expressions of 13 kinds of high-risk HPV (HR-HPV) types were detected. Meanwhile, MCM2 immunocytochemical test was performed on liquid-based pap smears from the 183 remained TCT samples. Those results were compared with the cervical histopathology results. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Affiliated Hospital of Inner Mongolia Medical University. Informed consent was obtained from all participates. Results The positive expression rate of MCM2 and HR-HPV were raised accompanying with the severity of cervical lesions. MCM2 expression with HR-HPV had significant consistency (P<0. 05). In 183 cases, the sensitivity of MCM2,HR- HPV types and the combination for detecting the CIN Ⅱ or worse were 93. 81%,88. 66% and 97. 94%,the specificity were 88. 0%,77. 55% and 91. 67%, respectively. While in 83 ASCUS cases, the sensitivity of MCM2, HR- HPV and the combination for detecting the CIN I or worse were 72. 09%,62. 79 % and 86. 05%,the specificity were 67. 57 % , 55. 56 % and 66. 67%,respectively. Whereas the sensitivity of them for detecting the CIN Ⅱ or worse were 86. 36%, 68. 18% and 90. 90%, the specificity were 91. 89%, 80. 56% and 88. 89%, respectively. Conclusions In cervical carcinoma and precancerous lesions,MCM2 is overexpressed and consistent with the HR-HPV expression. As MCM2 immunocytochemical detection is better than HR-HPV detection, MCM2 may serve as a useful marker in the screening of cervical carcinoma and precancerous lesions and help in further upgrading the diagnosis of ASCUS. The joint application can improve the sensitivity and specificity of diagnosis,but in ASCUS management MCM2 immunocytochemical detection has higher specificity. Key words: minichromosome maintenance protein 2; human papillomavirus; cytological techniques; uterine cervical neoplasm