Telomerase activity in Papanicolaou smear-negative exfoliated cervical cells and its association with lesions and oncogenic human papillomaviruses

Objective. The goal of this study was to evaluate telomerase activity in ex foliated cervical cells and its association with cytology, pathology, and h uman papillomavirus (HPV). Methods. Telomerase activity and HPV DNA sequences were examined in the exf oliated cervical cells from a general population of 245 women aged more tha n 30 years undergoing routine cervical screening by Papanicolaou smear. The women who were found to have telomerase activity or abnormal cytology in t heir exfoliated cervical cells were examined for cervical lesions by colpos copy and biopsy. Results. Cytology for our population (mean, 56 years) revealed only one abn ormal smear (1/245, 0.4%), in which a cervical intraepithelial neoplasia gr ade I (CIN I) lesion was found. The exfoliated cervical cells used to prepa re the smear were negative for telomerase and contained low-risk HPV DNA. T elomerase activity was found in 16 exfoliated cell samples (16/245, 6.5%); high-risk HPV DNA was found in 9 of these samples (9/16, 56%) and 9 of the biopsy specimens that could be evaluated from patients testing positive for telomerase revealed CIN I lesions (9/11, 82%). Conclusions. Telomerase activity is often associated with highrisk HPV infe ction and it is suggested that telomerase assay can help to detect occult c ervical lesions. (C) 2000 Academic Press.