人类染色体端粒酶基因在宫颈病变中的表达及临床意义

Expression and clinical significance of hTERC gene in cervical lesions

目的探讨应用荧光原位杂交(FISH)技术检测人类染色体端粒酶(hTERC)基因异常扩增在子宫颈病变中的临床意义。方法用FISH技术检测118例宫颈脱落细胞中hTERC基因异常扩增情况。结果118例患者病理学诊断为炎症12例,宫颈上皮内瘤变(CIN)Ⅰ46例,CINⅡ31例,CINⅢ18例,浸润癌11例。FISH检测hTERC基因异常扩增阳性率在炎症组为0,CINⅠ组19.6%(9/46),CINⅡ组51.6%(16/31),CINⅢ组77.8%(14/18),浸润癌组90.9%(10/11),各组间比较差异有统计学意义(P<0.01)。通过对未治疗的CINⅠ和CINⅡ患者共26例进行随访,发现hTERC基因扩增预测CINⅠ、CINⅡ病变进展的敏感性83.3%,预测病变维持或消退的特异性90.0%。结论 hTERC基因的异常扩增随宫颈病变级别增高而增加,对宫颈病变的筛查有一定临床意义,检测hTERC基因的异常扩增对宫颈早期病变进展有预测意义,可作为监测宫颈病变进展的生物遗传学指标。

Objective To investigate the expression and clinical significance of abnormal human telomerase RNA gene component（hTERC） gene amplification tested by fluorescence in situ hybridization （FISH ） in cervical lesions .Methods Abnormal amplification of hTERC gene in exfoliated cells was detected by FISH in 118 pa-tients .The results were then compared with pathologic findings .Results Cervical biopsy revealed inflammation in 12 patients ,CINⅠ in 46 patients ,CINⅡ in 31 patients ,CINⅢ in 18 patients ,and infiltrating carcinoma in 11 patients .In the inflammation ,CIN Ⅰ ,CIN Ⅱ ,CIN Ⅲ and infiltrating carcinoma group , the positive rates of hTERC gene amplification were 0 ,19.6% （9/46） ,51.6% （16/31） ,77.8% （14/18） and 90.9% （10/11） respec-tively （P＆lt;0.01） .In 26 patients with untreated CIN Ⅰ and CIN Ⅱ ,the sensitivity of detection of hTERC gene amplification to predict lesion progression was 83.3% ,and the specificity was 90.0% .Conclusion Abnormal am-plification of hTERC gene increased with the increasing grade in cervical lesions .Detection of abnormal amplifica-tion of hTERC gene is of predictive significance for progression of CIN Ⅰ /Ⅱ ,so it can assist in screening cervical lesions and identifying CINⅠ /Ⅱ patients with a high progression risk .