hTERC基因在预测宫颈上皮内瘤变1级患者转归中的价值

Value of hTERC gene in predicting outcomes of mild cervical intraepithelial neoplasia

目的探讨人端粒酶RNA(hTERC)基因在预测宫颈上皮内瘤变1级(CIN1)患者疾病转归的价值。方法病理诊断为CIN1的患者118例,实施宫颈环形电切术患者56例(A组),未行手术患者62例(B组)。均收集宫颈脱落细胞,用荧光原位杂交法检测hTERC基因,并据此又分为hTERC基因阳性(A1和B1)组和阴性(A2和B2)组。以宫颈液基细胞学(TCT)检查联合高危型人乳头瘤病毒(HR-HPV)DNA检测(HC-Ⅱ)作为随访指标,必要时行阴道镜下多点活检并行病理检查。结果 115例(97.5%)完成随访24个月。B1组的病变逆转低于B2组(P<0.05);A1组和A2组患者疾病的转归相仿(P>0.05)。B1组HPV转阴率低于B2组(P<0.05);A1组和A2组的HPV转阴率相仿(P>0.05)。结论 2年内,hTERC基因阳性的CIN1患者有较高的CIN发生风险,HPV转阴率低。宫颈环切术可以改善hTERC基因阳性CIN1患者的预后。hTERC基因或许可以作为预测CIN1患者转归的一项生物学指标。

Objective To study the value of human telomerase RNA component（hTERC） gene in predicting the outcomes in patients with mild cervical intraepithelial neoplasia（CIN1）. Methods Of 118 CIN1 patients, 56 cases underwent cervix fibrotomy（group A） and 62 cases did not （group B）. The expression of hTERC gene was detected by fluorescence in situ hybridization technique, on the basis of which, groups of A and B were divided into two groups of A1 （hTERC positive）, A2 （hTERC negative）, B1 （hTERC positive） and 132 （hTERC negative）. The patients were followed up for 2 years, during which cervical liquid-based cytology （TCT） and high-risk HPV test （HC-Ⅱ）, including necessity biopsies, were performed. Results A total of 115 （97.5%） patients was followed up completely for 24 months. The high-grade CIN progression rate was lower in group B1 than that in group 132 （P〈0. 05）, which in groups of A1 and A2 was similar （P〉0. 05）. The HPV negative conversion ratio was lower in group B1 than that in group B2（P〈0. 05）,which in groups of A1 and A2 was similar（P〉0. 05）. Conclusion hTERC gene positive CIN1 patients have a high risk for CIN occurrence with a lower HPV negative conversion ratio in 2 years. Surgery can improve the prognosis of CIN1 patients, hTERC gene may be taken as a biological indicator in predicting the prognosis of CIN1 patients.