Telomerase-A molecular marker for cervical cancer screening

Cervical cancer is one of the most common cancers in women and can be routi nely screened for by the Papanicolaou smear. Screening for HPV high-risk ty pes 16 and 18 has augmented the sensitivity of this test, but still some ca ses remain undetected. We have investigated the utility of assaying telomer ase activity as a possible screening marker for cervical cancer. Telomerase activity was studied in relation to HPV 16/18 infection, Papanicolaou smea r cytopathology and biopsy histopathology in a total of 88 subjects, consis ting of 29 cervical cancer cases, 19 control hysterectomy samples, 16 preca ncerous cervical scrapes, 6 cervical samples from other gynecological malig nancies, and 18 normal healthy cervical scrapings. Telomerase activity was detected in 96.5% of cervical tumor samples and in 68.7% of premalignant ce rvical scrapings but was not detected in control hysterectomy samples and i n cervical scrapings of normal healthy controls. Telomerase assay had a dia gnostic accuracy of 95.8 in tissue samples, 79.1 in scrapings and 91.2 in a ll. Whereas HPV-16/18 subtyping had a diagnostic accuracy of 89.5% in tissu e samples, 70.5% in scrapings, and 82.1% in all. There was also 71% agreeme nt between telomerase activity and HPV-16/18 infection. The absence of telo merase activity in cervical scrapes from healthy women indicated the potent ial of telomerase to serve as a good screening marker for the early diagnos is of cervical cancer. For the first time we have also shown the ability of telomerase to detect micro and probably occult metastasis in gynecological malignancies.