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High Expression of Human Telomerase Reverse Transcriptase in High-Grade Intraepithelial Neoplasia and Carcinoma of Uterine Cervix and Its Correlation With Human Papillomavirus Infection

Department of Obstetrics and Gynecology, Chung Shan Medical University Taichung, Taiwan, School of Medicine, Chung Shan Medical University Taichung, Taiwan, Institute of Medicine, Chung Shan Medical University Taichung, Taiwan

Gin-Den Chen, MD

Department of Obstetrics and Gynecology, Chung Shan Medical University Taichung, Taiwan, School of Medicine, Chung Shan Medical University Taichung, Taiwan

Han Chang, MD, PhD

School of Medicine, Chung Shan Medical University Taichung, Taiwan, Institute of Medicine, Chung Shan Medical University Taichung, Taiwan, Department of Pathology, Chung Shan Medical University Taichung, Taiwan

Shun-Fa Yang, PhD

Institute of Medicine, Chung Shan Medical University Taichung, Taiwan

Chih-Ping Han, MD, PhD

Clinical Research Center Chung Shan Medical University Taichung, Taiwan

Long-Yau Lin, MD, PhD

Department of Obstetrics and Gynecology, Chung Shan Medical University Taichung, Taiwan, School of Medicine, Chung Shan Medical University Taichung, Taiwan, Institute of Medicine, Chung Shan Medical University Taichung, Taiwan

Jiunn-Liang Ko, PhD

Institute of Medical and Molecular Toxicology (J-LK), Chung Shan Medical University, Taichung, Taiwan, ming84921345{at}yahoo.com.tw

Most of cervical intraepithelial neoplasia 1 (CIN 1) will regress and 12% to 40% of high-grade CIN may progress to squamous cell carcinoma (SCC) of the uterine cervix. However, the differentiation of CIN 1 and high-grade CIN is sometimes controversial among pathologists. Human telomerase reverse transcriptase (hTERT) is therefore applied to detect the differences among normal, CIN 1, high-grade CIN, and SCC tissues of uterine cervix. One hundred six cervical specimens were collected for immunohistochemical study of hTERT. These data were compared with the human papillomavirus (HPV) DNA status. Expression of hTERT in high-grade CIN increased significantly compared to that in CIN 1 ( P < .001). A positive relationship was found between high hTERT expression and degree of malignant transformation ( P < .001). Most of the cases with high hTERT expression tested positive for the high-risk HPV groups. High hTERT expression was detected in 88.73% of the samples with cervical high-grade CIN or SCC. Low hTERT expression was found in 94.29% of low-grade CIN or normal tissues. Furthermore, 96.92% of the cervical tissues with high hTERT expression were high-grade CIN or SCC. A total of 80.49% of samples with low hTERT expression were low-grade CIN or normal tissues. A significantly increased hTERT expression between CIN 1 and high-grade CIN exhibits a critical progression in cervical carcinogenesis. hTERT can be offered as additional molecular information correlated with more severe dysplasia and SCC. Furthermore, this increased hTERT expression is correlated whigh-risk HPVs infection.

Key Words: Human telomerase reverse transcriptase • high-grade cervical intraepithelial neoplasia • squamous cell carcinoma • human papillomavirus.

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