荧光原位杂交检测宫颈脱落细胞端粒酶基因扩增临床价值的探讨

Fluorescence in situ hybridization detection of abnormal cervical cytology in the clinical significance of telomerase

目的:检测宫颈脱落细胞中端粒酶基因扩增的检出率,探讨其在宫颈病变中诊断的价值。方法:收集2007-07-27-2009-01-09哈尔滨医科大学附属第三临床医学院妇科113例宫颈脱落细胞标本,其中非典型鳞状上皮细胞(ASC)患者27例、低度鳞状上皮内病变(LSIL)患者33例、高度鳞状上皮内病变(HSIL)患者26例、宫颈鳞癌(SCC)患者2例以及正常细胞学妇女25位,用荧光原位杂交技术(FISH)检测脱落细胞人类染色体末端酶基因(hTERC)扩增情况,ASC以上各组进行病理组织学检查。结果:在ASC组、LSIL组、HSIL组、SCC组和正常组宫颈脱落细胞中,hTERC基因扩增检出率分别为44.4%(12/27)5、7.6%(19/33)、92.3%(24/26)、100.0%(2/2)和0,ASC组、LSIL组、HSIL组、SCC组与正常组比较,差异有统计学意义,P<0.001。在子宫颈上皮内瘤样病变(CIN)Ⅰ、CINⅡ/Ⅲ和SCC患者中,hTERC基因扩增检出率分别为60.0%(18/30)、73.9%(34/46)和100.0%(5/5),CINⅠ组、CINⅡ/Ⅲ组、SCC组与正常组比较,差异有统计学意义,P=0.001。结论:hTERC基因在CIN和SCC中表达异常,其拷贝数随病理学及细胞学分级增加而增加,可作为宫颈癌筛查的有效指标和癌前病变进展的生物遗传学监测指标。

OBJECTIVE： To investigate the amplification detection rate of the telomerase gene in exfoliated cells of cervical state for the diagnostic value of cervical lesions. METHODS：from July 27th 2007 to January ninth 2009, in the third affiliated clinical medical school of haerbin medical university, 113 cases of cervical exfoliated cells gynecological specimens, 27 cases in which atypical squamous cells（ASC） patients, light-grade squamous intraepithelial lesion （LSIL） 33 patients, high-grade squamous intraepithelial lesion （HSIL） 26 patients, 2 cases of cervical squamous cell carcinoma （SCC）, normal cytology in 25 cases of women using fluorescence in situ hybridization （FISH） to detect exfoliated cells of human chromosome ends gene （human telomerase gene, hTERC） hTERC gene amplification. These results above of ASC were compared with histopathological results. RESULTS： hTERC gene in the group of ASC, LSIL, HSIL, SCC, and normal women with cervical cytology in exfoliated cells, amplification of hTERC detection rate was 44.4%（12/27）, 57. 6% （19/33）, 92. 3%（24/26） and 100. 0% （2/2）, 0. Comparison between groups （P〈0. 001）, hTERC gene amplification detection rate difference was statistically significant. hTERC gene in CIN Ⅰ , CINⅡ/Ⅲ and SCC, the amplification rates were 60.0M（18/30）, 73.9%（34/46） and 100.0%（5/5）. Ⅰ , CINⅡ/Ⅲ, SCC group compared with the normal control group, there was significant difference （P = 0. 001 ）. CONCLUSION： hTERC gene in CIN and SCC in the abnormal expression and its copy numbers are increased with the serious degree of pathological and cytological grades, can be used as an effective indicator of cervical cancer screening and precancerous lesions of progress monitoring indicators of biological genetics.