Diagnostic Value of TERC Gene on High-Grade Squamous Intraepithelial Lesion of the Cervix: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

OUYA Menglan , LI Li ,  GAO Kun

Department of Gynecologic Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning 530021, China;

Corresponding author：

GAO Kun, Email: kungaomail@126.com

Keywords：

TERC gene; Cervical cancer; Meta-analysis; Systematic review; Diagnostic test

DOI：

10.7507/1672-2531.20130056

Video：

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Objective 　To systematically evaluate the diagnostic value of TERC gene on high-grade squamous intraepithelial lesion (HGSIL) of the cervix.
Methods 　Such databases as PubMed, EMbase, and The Cochrane Library were searched by March 31, 2012. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and the meta-analysis was conducted by using Meta-Disc 1.4 software.
Result 　A total of 12 studies involving 7 894 cases were included. The results of meta-analysis showed that the sensitivity, specificity and diagnostic odds ratios of TERC gene on HGSIL of cervix were 0.81 (95%CI 0.80 to 0.82), 0.83 (95%CI 0.82 to 0.84), 17.37 (95%CI 8.77 to 34.41), respectively.
Conclusions 　The diagnostic value of TERC gene were medium in diagnosing HGSIL of the cervix alone, and it can be used as an optional method in clinical diagnosis.

Citation： OUYA Menglan,LI Li,GAO Kun. Diagnostic Value of TERC Gene on High-Grade Squamous Intraepithelial Lesion of the Cervix: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(3): 325-331. doi: 10.7507/1672-2531.20130056 Copy

1.	李克敏, 尹如铁. 人类乳头状病毒检测诊断宫颈癌前病变的价值: 随机对照研究的系统评价. 中国循证医学杂志, 2011, 11(8): 910-918.
2.	Heselmeyer-Haddad K, Janz V, Castle PE, et al. Detection of Genomic Amplification of the Human Telomerase Gene (TERC) in Cytologic Specimens as a Genetic Test for the Diagnosis of Cervical. Dysplasia American Journal of Patholog, 2003, 163: 1406-1416.
3.	Heselmever-Haddad K, Sommerfeld K, White NM, et al. Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer. American Journal of Pathology, 2005, 166: 1229-1238.
4.	Naney RC, Craway AK, Marilyn D, et al. Gain of the 3q26 region incervicovaginal liquid-based pap preparations is associated with squamous intraepithelial lesions and squamous cell carcinoma. Gynecologic Oncology, 2008, 110: 37-42.
5.	Costa C, EsPinet B, Molina MA, et al. Analysis of gene status in cervical dysplastic lesions and squamous cell carcinoma using tissue microarrays. Histol Histopathol, 2009, 24(7): 821-829.
6.	Yuan YL, He CN, Xu MT, et al. Detection of TERC gene amplification by fluorescence in-situ hybridization in cervical intraepithelial lesions. Chinese Journal of Pathology, 2011, 40(3): 182-186.
7.	Jiang J, Wei LH, Li YL, et al. Detection of TERC amplification in cervical epithelial cells for the diagnosis of high-grade cervical lesions and invasive cancer: a multicenter study in China. J Mol Diagn, 2010, 12(6): 808-817.
8.	Voss JS, Kipp BR, Campion MB, et al. Assessment of fluorescence in situ hybridization and hybrid capture 2 analyses of cervical cytology specimens diagnosed as low grade squamous intraepithelial lesion for the detection of high grade cervical intraepithelial neoplasia. Anal Quant Cytol Histol, 2010, 32(3): 121-130.
9.	Andersson S, Sowjanya P, Wangsa D, et al. Detection of genomic amplification of the human telomerase gene TERC, a potential marker for triage of women with HPV-positive, abnormal Pap smears. Am J Pathol, 2009, 175(5): 1831-1847.
10.	Kokalj-Vokac N, Kodric T, Erjavec-Skerget A, et al. Screening of TERC gene amplification as an additional genetic diagnostic test in detection of cervical preneoplastic lesions. Cancer Genet Cytogenet, 2009, 195(1): 19-22.
11.	Wisman GB, De Jong S, Meersma GJ, et al. Telomerase in (pre)neoplastic cervical disease. Hum Pathol, 2000, 31(10): 1304-1312.
12.	Theelen W, Speel EJ, Herfs M, et al. Increase in viral load, viral integration, and gain of telomerase genes during uterine cervical carcinogenesis can be simultaneously assessed by the HPV 16/18 MLPA-assay. Am J Pathol, 2010, 177(4): 2022-2033.
13.	Zhang Y, Wang X, Ma L, et al. Clinical significance of hTERC gene amplification detection by FISH in the screening of cervical lesions. J Huazhong Univ Sci Technolog Med Sci, 2009, 29(3): 368-371.
14.	Reesink-Peters N, Helder MN, Wisman GB, et al. Detection of telomerase, its components, and human papillomavirus in cervical scrapings as a tool for triage in women with cervical dysplasia. J Clin Pathol, 2003, 56(1): 31-35.
15.	Lanham S, Herbert A, Watt P. HPV detection and measurement of HPV-16, telomerase, and survivin transcripts in colposcopy clinic patients. J Clin Pathol, 2001, 54(4): 304-308.
16.	Riethdorf S, Riethdorf L, Schulz G, et al. Relationship between telomerase activation and HPV 16/18 oncogene expression in squamous intraepithelial lesions and squamous cell carcinomas of the uterine cervix. Int J Gynecol Pathol, 2001, 20(2): 177-185.
17.	Li Y, Zeng WJ, Ye F, et al. Application of hTERC in thinprep samples with mild cytologic abnormality and HR-HPV positive. Gynecologic Oncology, 2011, 120(1): 73-83.
18.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Method, 2003, 10(3): 25.
19.	Lee DK, Kim BC, Kim IY, et al. The human papilloma virus E7 oncoprotein inhibits transforming growth factor-be-tasignaling by blocking binding of the Smad complex toits target sequence. J Biol Chem, 2002, 277(4): 38557-38564.
20.	Favre Bonvin A, Reynaud C, Kretz Remy C, et al. Human Papilloma virus type 18 E6 protein binds the cellular PDZ protein TIP-2/GIPC, which is involved in transforming growth factor beta signaling and triggem its degradation by the proteasome. J Virol, 2005, 79: 4229-4237.
21.	Mark RP, Trent H, Roger DP, et al. Selection of cervical keratinocytes containing integrated HPV16 associates with episome loss and an endogenous antiviral response. PNAS, 2006, 103(10): 3822-3827.
22.	Caraway NP, Khanna A, Dawlett M, et al. Gain of the 3q26 regin in cervicovaginal liquid-based pap preparations is associated with squamous intraepithelial lesions and squamous cell carcinoma. Gynecol Oncol, 2008, 110(1): 37-42.
23.	李静然, 魏丽惠. 应用双色间期FISH技术中宫颈脱落细胞取材及制片方法的探讨. 中国妇产科临床杂志, 2007, 8(6): 435-438.
24.	Ramsaroop R, Oei P, Ng D, et al. Cervical intraepithelial neoplasia and aneusomy of TERC: assessment of liquid-based cytological preparations. Diagn Cytopathol, 2009, 37(6): 411-415.

1. 李克敏, 尹如铁. 人类乳头状病毒检测诊断宫颈癌前病变的价值: 随机对照研究的系统评价. 中国循证医学杂志, 2011, 11(8): 910-918.
2. Heselmeyer-Haddad K, Janz V, Castle PE, et al. Detection of Genomic Amplification of the Human Telomerase Gene (TERC) in Cytologic Specimens as a Genetic Test for the Diagnosis of Cervical. Dysplasia American Journal of Patholog, 2003, 163: 1406-1416.
3. Heselmever-Haddad K, Sommerfeld K, White NM, et al. Genomic Amplification of the Human Telomerase Gene (TERC) in Pap Smears Predicts the Development of Cervical Cancer. American Journal of Pathology, 2005, 166: 1229-1238.
4. Naney RC, Craway AK, Marilyn D, et al. Gain of the 3q26 region incervicovaginal liquid-based pap preparations is associated with squamous intraepithelial lesions and squamous cell carcinoma. Gynecologic Oncology, 2008, 110: 37-42.
5. Costa C, EsPinet B, Molina MA, et al. Analysis of gene status in cervical dysplastic lesions and squamous cell carcinoma using tissue microarrays. Histol Histopathol, 2009, 24(7): 821-829.
6. Yuan YL, He CN, Xu MT, et al. Detection of TERC gene amplification by fluorescence in-situ hybridization in cervical intraepithelial lesions. Chinese Journal of Pathology, 2011, 40(3): 182-186.
7. Jiang J, Wei LH, Li YL, et al. Detection of TERC amplification in cervical epithelial cells for the diagnosis of high-grade cervical lesions and invasive cancer: a multicenter study in China. J Mol Diagn, 2010, 12(6): 808-817.
8. Voss JS, Kipp BR, Campion MB, et al. Assessment of fluorescence in situ hybridization and hybrid capture 2 analyses of cervical cytology specimens diagnosed as low grade squamous intraepithelial lesion for the detection of high grade cervical intraepithelial neoplasia. Anal Quant Cytol Histol, 2010, 32(3): 121-130.
9. Andersson S, Sowjanya P, Wangsa D, et al. Detection of genomic amplification of the human telomerase gene TERC, a potential marker for triage of women with HPV-positive, abnormal Pap smears. Am J Pathol, 2009, 175(5): 1831-1847.
10. Kokalj-Vokac N, Kodric T, Erjavec-Skerget A, et al. Screening of TERC gene amplification as an additional genetic diagnostic test in detection of cervical preneoplastic lesions. Cancer Genet Cytogenet, 2009, 195(1): 19-22.
11. Wisman GB, De Jong S, Meersma GJ, et al. Telomerase in (pre)neoplastic cervical disease. Hum Pathol, 2000, 31(10): 1304-1312.
12. Theelen W, Speel EJ, Herfs M, et al. Increase in viral load, viral integration, and gain of telomerase genes during uterine cervical carcinogenesis can be simultaneously assessed by the HPV 16/18 MLPA-assay. Am J Pathol, 2010, 177(4): 2022-2033.
13. Zhang Y, Wang X, Ma L, et al. Clinical significance of hTERC gene amplification detection by FISH in the screening of cervical lesions. J Huazhong Univ Sci Technolog Med Sci, 2009, 29(3): 368-371.
14. Reesink-Peters N, Helder MN, Wisman GB, et al. Detection of telomerase, its components, and human papillomavirus in cervical scrapings as a tool for triage in women with cervical dysplasia. J Clin Pathol, 2003, 56(1): 31-35.
15. Lanham S, Herbert A, Watt P. HPV detection and measurement of HPV-16, telomerase, and survivin transcripts in colposcopy clinic patients. J Clin Pathol, 2001, 54(4): 304-308.
16. Riethdorf S, Riethdorf L, Schulz G, et al. Relationship between telomerase activation and HPV 16/18 oncogene expression in squamous intraepithelial lesions and squamous cell carcinomas of the uterine cervix. Int J Gynecol Pathol, 2001, 20(2): 177-185.
17. Li Y, Zeng WJ, Ye F, et al. Application of hTERC in thinprep samples with mild cytologic abnormality and HR-HPV positive. Gynecologic Oncology, 2011, 120(1): 73-83.
18. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Method, 2003, 10(3): 25.
19. Lee DK, Kim BC, Kim IY, et al. The human papilloma virus E7 oncoprotein inhibits transforming growth factor-be-tasignaling by blocking binding of the Smad complex toits target sequence. J Biol Chem, 2002, 277(4): 38557-38564.
20. Favre Bonvin A, Reynaud C, Kretz Remy C, et al. Human Papilloma virus type 18 E6 protein binds the cellular PDZ protein TIP-2/GIPC, which is involved in transforming growth factor beta signaling and triggem its degradation by the proteasome. J Virol, 2005, 79: 4229-4237.
21. Mark RP, Trent H, Roger DP, et al. Selection of cervical keratinocytes containing integrated HPV16 associates with episome loss and an endogenous antiviral response. PNAS, 2006, 103(10): 3822-3827.
22. Caraway NP, Khanna A, Dawlett M, et al. Gain of the 3q26 regin in cervicovaginal liquid-based pap preparations is associated with squamous intraepithelial lesions and squamous cell carcinoma. Gynecol Oncol, 2008, 110(1): 37-42.
23. 李静然, 魏丽惠. 应用双色间期FISH技术中宫颈脱落细胞取材及制片方法的探讨. 中国妇产科临床杂志, 2007, 8(6): 435-438.
24. Ramsaroop R, Oei P, Ng D, et al. Cervical intraepithelial neoplasia and aneusomy of TERC: assessment of liquid-based cytological preparations. Diagn Cytopathol, 2009, 37(6): 411-415.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of TERC Gene on High-Grade Squamous Intraepithelial Lesion of the Cervix: A Meta-Analysis

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