CERVICAL CANCER

Cervical cancer is a major malignant tumor that seriously threatens women’s health, and its incidence rate ranks second among female reproductive system malignancies. At present, the widespread application of cervical cytology screening and HPV testing have significantly reduced the incidence and mortality of cervical cancer, but the current screening procedures still have certain limitations. For young women, mild cytologic abnormalities are common, and most will naturally return; HPV infection may be short-lived and may naturally turn negative. More importantly, cervical cytology screening does not distinguish well between cervical intraepithelial neoplasia (CIN) and predict whether it progresses. The development of CIN for cervical cancer is a long-term process, and early diagnosis and appropriate treatment may completely block it in the CIN or early stage of cancer and cure it completely. However, not all CIN lesions progress to high lesions, and the currently used morphological diagnosis-based methods sometimes make it difficult to accurately identify CIN and non-tumor lesions, different levels of CIN, resulting in over-treatment or under-treatment. Therefore, other means are needed to assist in the diagnosis of CIN.
Recent studies have shown that cervical cell carcinogenesis is almost accompanied by the amplification of the long arm of chromosome 3, and the most important gene involved may be the telomerase RNA gene (TERC), which can prevent cell apoptosis. Death leads to the development of tumors. Sufficient data suggest that as the level of cervical lesions increases, the positive rate of TERC gene amplification increases. For example, the proportion of TERC gene amplification in CIN I samples is about 10%, while the proportion of TERC gene amplification in CIN II samples is as high as 60%. When the patient’s pathological examination cannot determine whether the condition is CIN I or CIN II, if the TERC gene is amplified, the probability of the patient being CIN II and above is 90%, and there is a possibility of canceration. Therefore, the detection of TERC gene amplification by FISH can contribute to the screening and early diagnosis of cervical cancer, and can help to define the pathological grade of precancerous lesions, thus suggesting that the clinical selection of reasonable treatment methods, to avoid over-treatment or inadequate treatment.