TERC/MYC联合检测在宫颈癌筛查中的临床意义

Clinical significance of combined detection of TERC and MYC gene expression in cervical cancer screening

目的探讨TERC/MYC联合检测在宫颈癌筛查中的临床意义。方法子宫颈细胞学检测将195例宫颈脱落细胞分组为无上皮内病或恶性病变(NILM)80例,不能明确意义(ASC-US)49例,低度病变(LSIL)25例,不能除外高度病变(ASC-H)19例,高度病变(HSIL)17例和鳞状细胞癌(SCC)5例,采用荧光原位杂交方法检测TERC和MYC基因拷贝数。结果 NILM、ASC-US、LSIL、ASC-H、HSIL和SCC患者中TERC阳性率分别为7.5%、18.4%、52.0%、57.9%、82.3%和100%。MYC阳性率分别为11.3%、24.5%、52.0%、52.6%、88.2%和100%。两者联合检测的阳性率分别为12.5%、30.6%、72%、78.9%、94.1%和100%。正常组(NILM)、低危组(ASC/LSIL)和高危组(HSIL/SCC)之间,TERC和MYC检测阳性率有显著性差异(P<0.01)。结论 TERC/MYC联合检测对于宫颈癌的分级,辅助细胞学检测有重要意义。

Objective To evaluate the clinical significance of combined detection of TERC/MYC in cervical cancer screening.Methods 195 cases were divided into six groups by cervical cytological examination 80 cases of intraepithelial lesion or malignancy（NILM）,49 cases of atypical squamous cells of undetermined significance（ASCUS）,25 case of low-grade squamous intraepithelial lesion（LSIL）,19 cases of atypical squamous cells that cannot be excluded for high-grade squamous intraepithelial lesion（ASC-H）,17 cases of high-grade squamous intraepithelial lesion（HSIL） and 5 cases of squamous cell carcinoma（SCC）.TERC/MYC expression was analyzed by fluorescence in situ hybridization.Results The positive rate of TERC in NILM,ASC-US,LSIL,ASC-H,HSIL and SCC was 7.5%,18.4%,52.0%,57.9%,82.3%and100%,respectively.The positive rate of MYC in NILM,ASC-US,LSIL,ASC-H,HSIL and SCC was 11.3%,24.5%,52.0%,52.6%,88.2%and 100%,respectively.The positive rate of combined detection of TERC/MYC was 12.5%、30.6%、72%、78.9%、94.1%and 100%,respectively.The differences among groups of NILM,ASC/LSIL,and HSIL/SCC were statistically significant（P 〈0.01）.Conclusion Combined detection of TERC/MYC has an important significance in cervical cancer classification and was a useful supplementary test method for cytological examination.