宫颈病变组织中端粒酶反转录酶基因表达的临床意义

Expression of human telomerase reverse transcriptase gene (TERT) in cytologic specimens as an affiliated diagnostic test for cervical dysplasia

目的探讨宫颈病变组织中端粒酶反转录酶(TERT)基因的表达和临床意义。方法对获取的208例宫颈脱落细胞标本进行细胞学诊断、组织学诊断,同时采用RT-PCR方法检测TERT基因的扩增情况。结果不明确意义鳞状上皮细胞(ASCUS)组、低度病变(LSIL)组、高度病变(HSIL)组、鳞状细胞癌(SCC)组与正常细胞学组比较,组间差异有统计学意义(χ2=16.441,P<0.0025);CIN1、2、3,SCC组与良性病变组TERT基因阳性率比较差异有统计学意义(P<0.001);TERT基因的表达率与细胞学诊断的病变程度呈正相关(R=0.342,P=0.0442<0.05),TERT基因的表达率与组织学诊断的病变程度呈正相关(R=0.527,P=0.0411<0.05)。结论TERT基因在宫颈癌和CIN病变中的表达有异常增加,可作为监测宫颈癌前病变病情进展的一个生物遗传学指标。

Objective To study the expression and clinical significance of the human telomerase gene in the specimens of cervical ceils. Methods Two hundred and eight specimens of cervical cells were collected from the outpatient department. Thinpre liquid cellular analysis system was used to give a cellular diagnosis, while RT-PCR was used to detect the TERT expressions in the specimens from the specimens. After histology biopsy results were given, the expression rates of TERT were also compared in different groups. Results The expression rate of TERT in the high grade cellular TBS diagnosis system was significant high than that in the low grade. A similarly result was also observed in the different histological diagnosis groups. The results showed that severity cervical intraepithelial neoplasia lesions could be distinguished from normal samples, atypical squamous cell of undetermined significance （ASCUS） and CIN1 by using TERT detection. Conclusion Detection of TERT may serve as an affiliated screening test to determine the progressive potential of individual lesions.