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DOI: 10.1055/s-0028-1088865
Companion of a FISH-Test and PAP-staining to detect precancerous lesion of the cervix
Objective:
Cervical cancers almost invariably carry extra copies of chromosome arm 3q and 8q, resulting in gains of hTERC and C-MYC. Both genes are involved in carcinogenesis. Cervical precancerous lesions are characterized routinely by cytological tests of PAP smears, without consideration of the genetic cell conditions. It is aim of this study to settle the following questions:
1) Does FISH on PAP stained smears allow a comparison of cell neoplasm and genetic status?
2) Does this complement the conventional PAP diagnoses and prognoses?
Material:
We use interphase FISH with a triple-colour probe panel (Kreatech) to quantify hTERC, C-MYC and chromosome 7 centromere, on cervical smears, including 111 Pap smears and 106 unstained smears.
Results:
The FISH test was successful on PAP smears (70.27%) as well as on unstained smears (78.30%) and allow a comparison between abnormal and normal cell morphs. The main pattern of morphologic abnormal cells was gene gain while the main pattern of morphologic normal cells was diploid. According to the progression of cervical lesion from normal, CINⅠ/Ⅱ to CINⅢ, the percentage of nuclei with relative hTERC or C-MYC gene gain is increased (p<0.001), while the percentage of diploid nuclei was reduced (p<0.001). According to the follow up data of 3 cases with PapIII, it was shown that patients with gene gain of hTERC or C-MYC got progression of cervical lesions in less than 1 year.
Conclusions:
Gene gains of hTERC and C-MYC are coincident to morphologic aberrance of cervical lesions. The genetic information could differentiate precancerous and normal cells, especially for PAPIII cases (=ASCUS) with unclear result.
Cervix - FISH - PAP