hTERC基因检测在青海地区藏族妇女宫颈病变诊断中的临床意义

Clinical Significance by Application of hTERC Gene Test Using FISH in Cervical Lesions of Tibetan Women in Qinghai Area

目的:探讨应用FISH技术检测人端粒酶基因(human telomerase gene,hTERC)异常扩增在青海地区藏族妇女宫颈病变筛查中的临床意义。方法:选择400例门诊高危藏族妇女患者为研究对象,分别进行液基细胞学检查(LCT)、人乳头状瘤病毒(HC-Ⅱ HPV-DNA)检测,同时进行hTERC基因FISH检测。对上述结果有一项阳性者行阴道镜活组织病理检查。并与病理结果金标准相对比。结果:400例患者中LCT正常细胞学患者320例,非典型细胞(ASC)17例,低度病变(LSIL)43例,高度病变(HSIL)18例,宫颈癌2例。HC-Ⅱ HPV-DNA检测阳性者133例。hTERC基因异常扩增在正常组织学中12例,LSIL中13例,HSIL中19例,宫颈癌中2例,阳性率分别为3.61%、28.26%、95.00%、100.00%。其阳性率在正常组与LSIL和HSIL及宫颈癌组比较,hTERC基因异常扩增阳性率随着病变程度增加而增加,各组间差异有统计学意义(P<0.01)。结论:hTERC基因的异常扩增随病变加重而增加,其检出率也提高。在宫颈癌发生、发展中起重要作用,对预测早期病变进展有预测意义。联合应用LCT和HPV-DNA检测可显著提高宫颈癌的早期检出水平。

Objective： To determine the effects of hTERC gene amplification using FISH in screen of cervical lesion of Tibetan women in Qinghai area. Methods：The hTERC gene was detected by FISH in 400 samples of Tibetan women with high risk cervical lesion and was confirmed pathologically by cervical biopsy using colposcopy after liquid- based cervical cytology （LCT）, and HPV -DNA detection by HC - Ⅱ. The results were compared with its gold standard. Results：320 of 400 cases received LCT had normal cytology, and 17 cases for ASC, 43 cases for LSIL, 18 cases for HSIL, 2 cases for cervical cancer. Patients with positive HC - Ⅱ HPV - DNA test were 133 cases. The positive rate of hTERC abnormal gene amplification was 3.61%, 28.26%, 95.00% and 100.00% in normal histology of samples, LSIL, HSIL and cervical cancer, respectively. As compared with normal group, hTERC abnormal gene amplification was higher with greater pathological lesion （P 〈 0.01 ）. Conclusions：The positive rate of hTERC gene amplification increased with more severe lesion, and it plays an important role in the occurrence and development of cervical cancer and prognosticates an early stage event related to disease.