荧光原位杂交检测宫颈上皮脱落细胞人端粒酶基因表达与人乳头瘤病毒的临床应用

Clinical application of detection of genomic expression of the TERC in cytological specimens of the cervix by fluorescence in situ hybridization

目的研究宫颈癌人端粒酶基因(TERC)的表达情况和宫颈癌人乳头瘤病毒(HPV)感染的相关性,评估荧光原位杂交(FISH)技术检测TERC基因的表达对子宫颈上皮内瘤样病变(CIN)发展到宫颈癌的预测价值。方法采用FISH技术进行子宫颈上皮脱落细胞TERC基因的检测,实验对象81例,病理正常组20例,CIN1组28例,CIN2组12例,CIN3组9例,宫颈癌组12例。同时利用实时荧光定量聚合酶链反应技术(FQPCR)检测这81例病人的HPV(16/18)感染情况。并进行宫颈癌与TERC基因和HPV的相关性分析。结果在不同病理分组中TERC基因检测和HPV检测的阳性率差异有统计学意义(P<0.05),TERC基因检测的阳性率在不同病理分组中的差异有统计学意义(P<0.05),HPV的阳性率在不同病理分组中的差异也有统计学意义(P<0.05),恶性程度越高差异越显著(P<0.01);宫颈癌组TERC基因异常表达阳性率是100%,HPV为91.7%。结论 TERC基因异常表达与宫颈癌的发生发展及HPV感染密切相关。TERC基因和HPV联合检测,有助于提高宫颈癌的早期诊断有重要价值。

Objective To investigate the correlation between cervical cancer and the expression of TERC gene and the infection of HPV and evaluate the predicting significance of the TERC gene expression in the progress from cervical intraepithelial neoplasia to cervical cancer by fluorescence in situ hybridization technique.Methods TERC gene expression in uterine epithelial exfoliated cells from 81 samples by the method of FISH,including 20 samples in healthy group,28 samples in CIN1 group,12 samples in CIN2 group,9 samples in CIN3 group and 9 samples in cervical cancer group.HPV infection was tested using fluorescence quantitative polymerase chain reaction technology in these 81 patients.The correlation analysis was taken between cervical cancer and TERC gene and HPV.Results Among different pathology groups,the difference of positive rate between TERC gene test and HPV test was significances statistics（P0.05）;The positive rate of TERC gene test was significances statistics in different pathology groups（P0.05）.The positive rate of HPV test was significances statistics in different pathology groups（P0.05）.The higher the malignant degree,the more significant the result could be（P0.01）.In cervical cancer group,the abnormal expression positive rate of TERC gene and HPV was 100% and 91.7%.Conclusion The abnormal expression of TERC gene is closely related to the process of cervical cancer and HPV infection.The combined detection of TERC gene and HPV can help early diagnosis of cervical cancer.