阴道脱落细胞检查联合人类染色体末端酶基因、c-myc 检测在宫颈癌诊断中的价值

The clinical value of Thinprep cytology test combined with h -TERC and c -myc in the diagnosis of cervical ;cancer

目的：探讨阴道脱落细胞检查（TCT）结合人类染色体末端酶基因（h-TERC）和 c-myc 检测在宫颈癌中的价值。方法运用免疫荧光原位杂交技术检测近三年来该院宫颈癌患者500例的宫颈脱落细胞中h-TERC 和 c-myc 的表达，将其检测结果与 TCT 检测结果比较，将上述三种结果的任一阳性检测再进行病理学诊断标准来确定，且以病理诊断为准进行分析。结果在所检测的500例患者中，TCT 异常者132例（26.4％），h-TECR 异常者90例（18．0％），c-myc 异常者80例（16．0％），将270例患者进行阴道宫颈活检技术，在这些病例中，宫颈慢性炎者120例，宫颈病变者150例，其中宫颈上皮瘤变 CINⅠ52例（38．2％），CINⅡ50例（36．4％），CIN Ⅲ30例（18．2％），宫颈癌18例（7．3％）。在所检测的病例中，用原位杂交检测了h-TERC 的含量，其检测结果依次为18．1％、45．4％、52．5％、65．9％、100．0％，同样的 c-myc 的结果依次为21.4％、48．9％、56．7％、59．9％、100．0％，随着 TCT 检测结果的病理程度越高，h-TERC 和 c-myc 的表达越高。结论h-TERC 和 c-myc 检测联合 TCT 更能有效地检测宫颈癌患者的病理程度。

Objective To explore the clinical value of Thinprep cytology test （TCT）combined with h -TERC and c -myc in the diagnosis of cervical cancer.Methods hTERC amplification was detected by dual -color interphase fluorescence in situ hybridization （FISH）,and the results were compared with TCT and histological examination.Examination the positive which TCT,h -TERC and c -myc by pathological examination.The final diag-nosis was determined by the pathological examination.Results TCT was abnormal in 26.4% of 500 case,18.0%abnormal h -TERC gene,16.0% abnormal c -myc gene.In 270 cases according to the cervical biopsy,the positive rate of chronic inflammation,cervical intraepithelial neoplasia （CIN）Ⅰ,CINⅡ,CINⅢ and cervical cancer：44.4%, 38.2%,36.4%,18.2%,and 7.3% respectively.The positive rates of h -TERC were 18.1%,45.4%,52.5%, 65.9% and 100.0%,respectively.The positive rates of c -myc were 21.4%,48.9%,56.7%,59.9% and 100.0%.With increased pathological grade,the expressions of h -TERC and c -myc were high.Conclusion TCT combined with h -TERC and c -myc can test cervical cancer more effective.