FISH检测hTERC基因在宫颈腺癌中的扩增及意义

Amplification and significance of the hTERC gene detected by FISH in cervical adenocarcinoma

目的:探讨人端粒酶RNA(hTERC)基因在宫颈腺癌中的扩增以及在宫颈腺癌诊断和预后评估中的价值。方法:收集南京医科大学附属南京妇幼保健院2006年1月～2009年12月诊断为宫颈腺癌的石蜡标本38例,并随机抽取同时期诊断为宫颈鳞状上皮内瘤变而腺体正常的37例标本作为对照,采用荧光原位杂交(FISH)方法检测hTERC基因在腺癌及对照组宫颈腺体中的扩增。结果:腺癌组hTERC基因扩增阳性率为84.21%(32/38),对照组阳性率为0%(0/37),两组差异有显著统计学意义(P<0.01)。hTERC基因扩增检测的灵敏度为84.21%(32/38),特异度为100%(37/37),阳性预测值为100%(32/32),阴性预测值为86.05%(37/43)。FISH检测结果显示,不同亚型的宫颈腺癌阳性检出率各不相同,高分化和中-低分化的宮颈腺癌hTERC基因扩增程度存在差异(P<0.05)。对照组杂交信号多为2∶2,而腺癌组异常扩增类型有2∶3、2∶4、2∶5、3∶3、4∶4及N∶N。不同hTERC基因扩增程度的腺癌预后结果差异无统计学意义(P>0.05)。结论:hTERC基因在宫颈腺癌中扩增,病理分化程度不同hTERC基因扩增有差异,可作为宫颈腺癌的病理诊断辅助指标,尚未发现hTERC基因扩增程度与宫颈腺癌的不良预后有相关性。

Objective：To investigate the amplification of the hTERC gene in cervical adenocarcinomas（CA） and its role in pathologic diagnosis and prognostic evaluation.Methods：A total of 38 paraffin-embedded samples were collected from patients diagnosed as CA in Nanjing Maternity and Child Health Hospital Affiliated to NJMU from Jan,2006 to Dec,2009,and 37 samples diagnosed cervical intraepithelial neoplasia（CIN） with normal cervical gland were severed as control group.These samples were analyzed using fluorescence in situ hybridization（FISH） to detect the amplification of hTERC gene in the both group.Results：The positive rate of hTERC expression in the adenocarcinoma group and the control group was 84.21%（32 / 38）and 0%（0 / 37）,respectively.There were significant differences（P 〈 0.01） between those two groups.The sensitivity of hTERC was 84.21%（32 / 38）,the specificity was 100%（37 / 37）,the positive predictive value was 100%（32 / 32）,the negative predictive value was 86.05%（37 / 43）.The results indicate that different subtypes of the cervical adenocarcinomas had different positive detection rate.The amplification of hTERC gene in well differentiated CA was different form that in moderate and poor differentiated CA（P 〈 0.05）.The most common hybridization signals of the control group were 2∶2,while the abnormal amplification of adenocarcinoma had 2∶3,2∶4,2∶ 5,3∶3,4∶4 and N∶N.According to information of the 30 patients with detailed follow-up,there was no correlation between prognosis and the different amplification levels（P 〉 0.05）.Conclusion：The hTERC amplification increases significantly in cervical adenocarcinomas,and the hTERC gene amplification level changes with the differentiation degree.It can be regarded as the pathological assisted diagnosis index of cervical adenocarcinomas.The correlation of the high-frequency amplification of hTERC and the poor prognosis of the cervical adenocarcinomas is as yet unknown.