RELATIONSHIP BETWEEN THE EXPRESSION OF HPV E6/E7 AND HTERC GENES AND THE PROGRESSION OF CERVICAL LESIONS AND THE SIGNIFICANCE OF COMBINED DETECTION IN EARLY SCREENING OF CERVICAL CANCER

Rui Xiang^#, Zhiling Yang^#, Jingyi Wang, Licui Ye, Xia Meng, Haifeng Liu^*

Department of Obstetrics and Gynecology, The 2nd Affiliated Hospital of Chengdu Medical College ( Nuclear Industry 416 Hospital), Chengdu 610000, Sichuan Province, China

Objective: To explore the relationship between the expression of human papillomavirus E6/E7 (HPV E6/E7) and human telomere (hTERC) genes and the progression of cervical lesions and the significance of combined detection in early screening of cervical cancer. 

Methods: 125 patients who underwent TCT examination in our hospital from June 2017 to February 2019 were selected for the study and were divided into normal group (NC) 25 cases, low-grade squamous intraepithelial neoplasia (CIN1) 33 cases, medium-grade squamous intraepithelial neoplasia (CIN2) 31 cases and high-grade squamous intraepithelial neoplasia (CIN3) 26 cases according to the results of pathological blood examination. 10 cases of invasive carcinoma group (ICC). According to modern cervical cytology (TBS classification), 25 cases were divided into NC group, 35 cases in ASCUS group (atypical squamous epithelial cells without definite diagnostic significance), 15 cases in LSIL group, 11 cases in ASCH group (atypical squamous epithelial cells including highly squamous epithelial lesions), 6 cases in AGC group, 28 cases in HSIL group, and 28 cases in ASCH group. There were 5 cases of squamous cell carcinoma (SCC). The cervical exfoliated cells were collected by TCT and the positive expression rate of HPV E6/E7 was detected by nucleic acid hybridization. The positive amplification of hTERC gene was detected by FISH. To establish ROC curve and analyze the significance of HPV E6/E7 and hTERC gene detection alone or in combination in early screening of cervical cancer. 

Results: The results showed that the positive expression of HPV E6/E7 and hTERC genes in NC group, ASCUS group, LSIL group, ASCH group, AGC group, HSIL group and SCC group increased, and the higher the grade of cytological lesions, the higher the positive expression of HPV E6/E7 and hTERC genes (P<0.05). The positive expression of HPV E6/E7 and hTERC genes in different histological classifications of NC, CIN1, CIN2, CIN3 and ICC groups showed an upward trend (P<0.05). With the increase of histological lesions, the positive expression rates of HPV E6/E7 and hTERC genes increased significantly, and the positive expression rates of HPV E6/E7 and hTERC genes in ICC group were as high as 100%. The results showed that the sensitivity and specificity of HPV E6/E7, hTERC and HPV E6/E7 + hTERC were 73.08%, 66.67%, 61.13%, 92.55%, 82.39%, 96.42%, respectively. The sensitivity and specificity of combined detection of HPV E6/E7 and hTERC genes were significantly higher than that of single detection. 

Conclusion: The expression of HPV E6/E7 and hTERC genes increased significantly with the increase of the degree of cervical cancer lesion. The above indices can reflect the development of cervical cancer to some extent, but the combined detection of HPV E6/E7 and hTERC has the highest significance in early screening of cervical cancer.