Women's Health

While squamous cell carcinoma has steadily decreased since the introduction on the Pap smear, adenocarcinoma remains an area of great concern.  The ability to detect adenocarcinoma is an essential part of comprehensive cervical cancer screening.

Virtually all cervical cancers are caused by HPV infections. However, the vast majority of infections regress. Several genetic abnormalities have been identified and correlated with the transformation of cervical cells to carcinoma. The identification of these genetic abnormalities can be used to predict which patients are likely to progress to cervical carcinoma.

FISH Assays:

TERC (3q26): Research has indicated that in increased copy number of the TERC gene is a strong predictor of progression from CIN1/CIN2 to CIN3 and invasive carcinoma in cervical lesions.1,2

MYC (8q24 ): Studies have demonstrated that a copy number increase in either 8q24 (MYC) and/or 3q26 (TERC) has the ability to identify which patients with a cervical cytology diagnosis of LSIL are most likely to have or progress to CIN2+ on clinical follow up.3

CTNND2 (5p15): Studies have revealed copy number gains in 5p in 43% of cervical carcinomas.  These studies have demonstrated gains of the entire 5p chromosomal arm which contains numerous potential oncogenes including CTNND2 at 5p15.4
 

References

1. Heselmeyer-Haddad K, Janz V, Castle PE, Chaudhri N, White N, Wilber K, Morrison LE, Auer G, Burroughs FH, Sherman ME, Ried T.: Detection of genomic amplification of the human telomerase gene (TERC) in cytologic specimens as a genetic test for the diagnosis of cervical dysplasia. Am J Pathol. 2003 Oct;163(4):1405-16.
2. Heselmeyer-Haddad K, Sommerfeld K, White NM, Chaudhri N, Morrison LE, Palanisamy N, Wang ZY, Auer G, Steinberg W, Ried T.: Genomic amplification of the human telomerase gene (TERC) in pap smears predicts the development of cervical cancer. Am J Pathol. 2005 Apr;166(4):1229-38.
3. Voss JS, Kipp BR, Campion MB, Sokolova IA, Henry MR, Halling KC, Clayton AC.: 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 Jun;32(3):121-30.
4. Gopeshwar Narayan and Vundavalli V Murty: Integrative genomic approaches in cervical cancer: implications for molecular pathogenesis. Future Oncol. 2010 October ; 6(10): 1643–1652.

Review our requisition for a complete list of the Women's Health services that we provide.