宫颈液基细胞学端粒酶基因扩增检测的意义

Implications of telomerase gene amplification in liquid-based cervical cytology

目的探讨人类染色体端粒酶(hTERC)基因在宫颈不同上皮内病变中的扩增情况及差异性,为临床治疗宫颈疾病提供依据。方法收集液基细胞学(LCT)剩余液体121例。经活检证实,正常或良性病变30例、CIN158例、CIN218例、CIN36例、浸润性鳞癌9例。采用荧光原位杂交技术(FISH)检测宫颈脱落细胞内hTERC基因扩增情况。结果 hTERC基因在不同病例中扩增率分别为:正常或良性病变6.67%(2/30);CIN122.41%(13/58);CIN272.22%(13/18);CIN3100%(6/6);鳞癌100%(9/9)。随着病变级别的增高,TERC基因扩增率不断升高。正常及CIN1者hTERC基因扩增率显著低于CIN2及CIN2以上者(P<0.01)。CIN2以上病变hTERC基因扩增敏感度为84.85%,特异度为93.34%。结论在宫颈的不同上皮病变中都有可能发生TERC基因的扩增,且随着病变程度的加重基因扩增发生率升高。

Objective To explore the human chromosome telomerase gene amplifications and their differences in hospitalized patients with different cervical intraepithelial lesions to provide guidance for clinical treatment. Methods Using the residual liquid of liquid-based cytology （LCT） and fluorescence in situ hybridization （FISH） to detect the hTERC gene amplification in 121 cases of cervical biopsy, in which normal or berrigu lesions were 30 cases, CIN1 were 58, CIN2 were 18, CIN3 were 6 and invasive cervical squamous cell carcinoma were 9, respectively. Results hTERC gene amplification rates in different cases were as follows ： benign lesions or normal was 6. 67% （2/30）, CIN1 was 22. 41% （ 13/58）, CIN2 was 72. 22% （ 13/18）, CIN3 was 100% （6/6）, and cervical cancer was 100% （9/9）. TERC gene amplification rates rose continuously with the grade of lesions. TERC gene amplification rates in normal cervix and CIN1 were significantly lower than that in CIN2 and more severe lesions （P 〈0. 01 ）. The sensitivity of hTERC gene amplification in patients with higher than CIN2 lesions was 84. 85% and specificity was 93. 34%. Conclusion TERC gene may be amplified in different cervical squamous intraepithelial lesions, and the amplification rates rise continuously with the grade of lesions.