FISH技术检测TERC基因在子宫颈上皮内瘤变1级与2级鉴别诊断中的实用价值

Practical value of TERC gene amplification by FISH in the differential diagnosis of cervical intraepithelial neoplasias 1 and 2

目的采用FISH技术检测TERC基因在子宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)不能明确1级或2级(CIN1/2)病变组织中的扩增,探讨其在CIN分级中的临床病理实用意义。方法选取子宫颈组织标本42例,其中正常子宫颈鳞状上皮20例,CIN1/2级22例(其中初步诊断1级8例,2级14例)。采用FISH技术检测石蜡包埋组织中TERC基因的扩增情况。结果正常子宫颈鳞状上皮中TERC基因无扩增,CIN1/2级组织中TERC基因的扩增率为22.7%(5/22),77.3%(17/22)的TERC基因无扩增;其中初步诊断1级8例,1例TERC基因扩增;初步诊断2级14例,4例TERC基因扩增,差异有统计学意义(P<0.05)。结论在石蜡包埋组织切片难以确定CIN1/2级时,应用FISH技术进行TERC基因检测,TERC基因扩增者可考虑为CIN2级,建议临床积极处理;无扩增者,考虑为CIN1级,可保守处理;FISH技术具有临床病理实用价值。

Purpose To explore the practical significance of TERC gene amplification by fluorescence in situ hybridization （ FISH） on the differential diagnosis of cervical intraepithelial neoplasias 1 and 2 by tissue microarray. Methods A total of 42 cases of cervical tissue samples were selected, including 20 cases of normal cervix, 22 cases of cervical intraepithelial neoplasia （CIN） 1/2 （8 cases of CIN1 and 14 CIN2）. Homemade tissue microarray was prepared. TERC gene amplification was detected with FISH method. Results TERC gene showed no amplification in the normal cervical squamous epithelium. TERC gene amplification was detected in 22. 7%（5/22）CIN1 and 77. 3%（17/22） in CIN2. 1/8 cases of TERC gene amplification in CIN1, 4/14 cases of TERC gene amplification in CIN2. There were significant differences in TERC gene amplification between those groups （P〈0. 05）. Conclusion The method is feasible and reliable in the detection of TERC gene amplification in CIN1/2 on paraffin sections. It has practical values in differential diagnosis between CIN1 and CIN2.