THE CLINICAL APPLICATION OF TCT, HPV, C-MYC GENE DETECTION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND CANCER SCREENING

Hui Wang^{1, *}, Min Deng¹, Lei Cao², Diqing Wang³, Zhigang He⁴

¹Department of Pathology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, 311400, China - ²Department of Dermatology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, 311400, China - ³Department of Cardiology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, 311400, China - ⁴Department of Gastroenterology, The First People's Hospital of Fuyang Hangzhou, Hangzhou, 311400, China

Introduction: To evaluate the performance of thinPrep cytological test (TCT), human papillomavirus (HPV) and c-MYC gene detection in cervical intraepithelial neoplasia and cancer screening. 

Materials and method: A total of 546 female patients aged 19-70 years were enrolled from the obstetrics and gynecology department. TCT, HPV and c-MYC genes detection were conducted on specimens from all patients. The screening results for gene prediction of cervical intraepithelial neoplasia and cancer were compared with histopathological diagnosis as the gold standard. The diagnostic reliability of gene prediction methods was assessed according to sensitivity, specificity, and receiver operating characteristic (ROC) curves.

Result: In line with the histopathological classification, there were 546 patients with 104 patients presenting inflammation, 101 patients with cervical intraepithelial neoplasia (CIN)Ⅰ, 156 patients with CIN Ⅱ, 155 patients with CIN Ⅲ, and 30 patients with invasive cervical cancer (ICC). The reliability of TCT single screening (the sensitivity and specificity were 75.11% 70.59%, respectively; AUC: 0.822; 95%CI: 0.781~0.864) is higher than other single method detections. The reliability of TCT + c-MYC parallel connection (the sensitivity and specificity were 81.00% and 90.38%, respectively; AUC: 0.861; 95%CI: 0.822~0.900) is higher than other combined methods.

Conclusion: In developed regions, TCT + c-MYC gene detection scheme can be selected, which, despite higher cost, has the highest clinical application value and the best effect . In moderately developed regions, TCT can be adopted with the highest sensitivity among single screening schemes and low misdiagnosis rate.