Interest of hTERT Expression as a Prognostic Marker in Precancerous and Cancerous Lesions of the Cervix in the Departments of Niari and Bouenza, Congo

Abstract

Introduction: Over expression of human telomerase reverse transcriptase (hTERT) plays an important role in the progression of cancer, which is predicted to have a poor prognosis. This work show the interest of the expression of the hTERT subunit of telomerase as a prognostic marker in the evolution of precancerous and cancerous lesions of the cervix in women in the departments of Niari and Bouenza. Method: A total of 98 dry tube blood samples collected between October 2020 and November 2021were tested to investigate hTERT expression. The assay was performed by third-generation Elisa enzyme immunoassay using the Human telomerase reverse transcriptase (hTERT) ELISA Kit; Sunlong Biotech Co., Ltd”. A study of the cytological profile by cervico-vaginal smear and pool genotyping by Xpert-HPV® had also been undertaken. Results:The average age of women was 43.26±11.52 years with extremities ranging from 24 to 73 years. The cytological profile of women subjected to hTERT expression was as follows: 87.65% of normal cytology, 10.11% of pre[1]cancerous lesions and 2.24% of patients with invasive cervical cancer. The prevalence of HPV-HR was 81.82% (9/11) of which 66.67 (6/11) was HPV16. The expression of hTERT in the general population was as follows: 44.94% of patients without expression, 48.31% of patients with expression and 6.75% with overexpression. Depending on cytology, overexpression of hTERT was observed in all patients with pre-cancerous and cervical cancer lesions. hTERT was overexpressed in 28.57% and expressed in 71.43% of ASCUS patients. 48.72%ofwomen with normal cytology also expressed hTERT. Among the 9 HPV positive patients, hTERT overexpression was observed in 44.45% of patients and expression in 33.33% of patients. HPV16 carriers also overexpressed and expressed hTERT in 33.33% and 22.22% respectively. Conclusion: The telomerase subunit hTERT has been shown to be a biomarker of poor prognosis whose expression is proportional to the stage of evolution of cervical lesions.