High-risk human Papillomavirus associated with TERT gene methylation in cervical cancer patients

Background: In cervical cancer (CC), the high-risk human papillomavirus (hr-HPV)-based screening is becoming increasingly important, either by supplementing or replacing the traditional cytology-based cervical Pap smear. Promising tools for diagnostic tests based on epigenetic markers such as DNA methylation are a research hotspot. Aim: The current study aims to evaluate the methylation profile of the TERT promoter region in CC and explore its relationship with hr-HPV infection. Methods: This study is a DNA methylation-based study of Telomerase Reverse Transcriptase (TERT), which took cervical scrapes from 60 CC patients and 30 subjects as controls. The DNA was extracted from the serum of the studied groups. Cervical swabs were subjected to real-time polymerase chain (RT-PCR) assay to reveal the hr-HPV positive cases. The TERT gene methylation was assessed by the qMethyl-PCR technique. Results: HPV-positive cases were slightly older on average (mean age 52.5 vs. 50.8 years; P = 0.608). The TERT gene methylation levels were significantly elevated in the HPV-positive group (0.480 vs. 0.279; P = 0.002). No significant association was observed between blood group and HPV status (P = 0.938); likewise, the number of children showed only minor, inconsistent shifts in HPV status distribution, lacking statistical significance (P = 0.323). Conclusion: Hypermethylation of the TERT gene may serve as a potential biomarker; its association appears to be influenced by the infection with hr-HPV in CC patients, which may provide a promising strategy for CC detection that complements the limited specificity of HPV testing by traditional cytology-based cervical Pap smear.