Combined detection of high- risk human papillomavirus and telomerase gene amplification in a mild cervical intraepithelial neoplasia shunt management role

Objective To discuss the significance of triage management for patients with mild cervical intraepithelial neoplasia( CIN) Ⅰ through combined detection of high-risk human papillomavirus load with the telomerase gene amplification.Methods Seventy-five cases of patients with CINⅠwho were confirmed pathologically were selected and divided into treatment group( n = 30) and control group( n = 45). The patients in treatment group underwent cervical loop electrosurgical excision procedure( LEEP) surgery while the control group had follow-up only according to the experimental requirements without any therapeutic intervention. The follow-up time was two years. High-risk human papillomavirus( HR-HPV) load and human telomerase mRNA component gene,h ETRC) amplification of all the patients were detected at the 12 months and 24 months after the beginning of follow-up. And colposcopy and cervical biopsy were implemented at 24 months after the beginning of follow-up in order to understand the outcomes and to end the follow-up. Results There were significant differences of HR-HPV load and h ETRC amplification before and after LEEP surgery in treatment group( P 0. 05). After the follow-up of two years,disease progression happened in one case( 3. 3%) of treatment group and five cases( 11. 1%) of control group,which had no significant difference( P 0. 05). The number of cases who had continuing and progress of the lesion in h TERC amplified positive patients was significantly higher than that in h TERC amplified negative patients of the control group( P 0. 05),and there was no significant difference of continuing and progress of the lesion between the cases with HR-HPV positive initial infection and negative initial infection( P 0. 05),while there was significant difference between HR-HPV infection sustained positive and HR-HPV infection sustained negative patients( P 0. 05). h TERC amplified positive relative risk was 3. 97 times of the negative,HR-HPV persistent infection relative risk was 1. 99 times of the negative. Combined detection of HR-HPV and h TERC were positive relative risk was 4. 54 times of those who were negative binomial. Conclusions The subsiding of CIN Ⅰis not completely due to cervical LEEP surgery,and blind over-treatment can not completely reverse the CINⅠ. Combined detection of HR-HPV and h TERC has some predictive value for the progress of CIN Ⅰ. Combined detection of the two indexes is expected to become diversion of management necessary screening method of CIN Ⅰ patients.