Genomic Amplification of hTERC in Paraffin-embedded Tissues of Cervical Intraepithelial Neoplasia and Invasive Cancer

Abstract

Cervical lesions and invasive cervical carcinomas are frequently associated with the amplification of chromosome 3q, which harbors the human telomerase gene hTERC. The differential diagnosis between low-grade and high-grade cervical lesions has been a clinical challenge in cytopathology. In the current study, we evaluated hTERC amplification by fluorescence in situ hybridization in cervical lesions with distinct histopathological changes and assessed the potential application of this technology in diagnosis. We showed that the frequency of genomic amplification of hTERC increased with the severity of the disease, with no marked difference between disease-free cervical squamous epithelium and Grade I cervical intraepithelial neoplasia(CIN)1, but that there were significant differences between these 2 stages and the CIN2, CIN3, and squamous cell carcinoma lesions. The difference between CIN1 and CIN2 would be of great importance for differential diagnosis in the clinic. In addition, hTERC amplification status exhibited a sensitivity of 59.42%, a specificity of 85.29%, an accuracy of 67.96%, a positive prediction value of 89.13%, and a negative prediction value of 68.42% in distinguishing CIN1 from CIN2/3 lesions. Therefore, hTERC amplification within cervical lesions can be accurately assessed by fluorescence in situ hybridization analysis on paraffin tissue microarrays. This technique may be clinically applied to differentiate between CIN1 and CIN2/3 lesions in paraffin-embedded biopsy tissues.