宫颈脱落细胞hTERC基因的表达及临床意义

Clinical Significance and Expression of the Human Telomerase Gene in Cytological Specimens of Cervix

目的探讨宫颈上皮内瘤变(CIN)和宫颈鳞癌(SCC)组织中人类染色体端粒酶基因(hTERC)的表达和临床意义。方法收集2007年10月-2009年6月经病理学证实的116例宫颈脱落细胞标本,其中LSIL(CINⅠ)30例、HSIL(CINⅡ/Ⅲ)37例、SCC16例、宫颈炎33例,用荧光原位杂交(FISH)方法检测脱落细胞hTERC基因。结果在宫颈炎、LSIL、HSIL和SCC组中hTERC基因的表达率分别是6.1%、16.7%、51.4%和93.8%,其中,HSIL、SCC组与宫颈炎组比较,hTERC基因阳性率差异有统计学意义(P<0.05),LSIL组与HSIL组比较、LSIL组与SCC组比较、HSIL组与SCC组比较,差异有统计学意义(P<0.05),且随着病变程度增加,hTERC基因表达率增加。结论 hTERC基因在细胞学LSIL、HSIL和SCC中表达异常,且随病变程度增加阳性表达率也增加,可作为宫颈癌癌前病变进展的生物遗传学监测指标,并有望成为宫颈癌早期筛查方法之一。

Objective To explore the clinical significance and expression of the human telomerase gene （hTERC） in the cervical intraepithelial neoplasia （ CIN） and squamous carcinoma of the cervix （ SCC）.Methods According to histological biopsy from October 2007 to June 2009,116 pap smears were divided into LSIL （n=30）,HSIL （n=37）,SCC （n =16）,and cervicitis （n=33） groups.Fluorescence in situ hybridization （FISH） was used to detect the expression of hTERC.Results Positive expression rate of hTERC was 6.1% in cervicitis group,16.7% in LSIL group,51.4% in HSIL group,and 93.8% in SCC group,respectively.Compared to cervicitis group,the expression of hTERC in HSIL and SCC groups was significantly higher （P0.05）.Among LSIL,HSIL,and SCC groups,there were significant differencec in hTERC expression between every two groups （P0.05）.From LSIL to SCC,the expression of hTERC increased obviously.Conclusion Abnormal expression of hTERC exists in LSIL,HSIL,and SCC patients,which significantly increases during malignant development.It may be a biogenetics monitor index of cervical precancerosis and will be a screening marker for cervical cancer.