FISH技术检测hTERC基因表达在宫颈病变诊治中的意义

The clinical significance of h TERC gene detection by FISH technique in the diagnosis and treatment of cervical lesions

目的:应用荧光原位杂交(FISH)技术检测宫颈脱落细胞中人端粒酶RNA(h TERC)基因的表达情况,探讨h TERC基因表达在宫颈病变诊治中的临床意义。方法:收集2014年12月至2016年10月在温州医科大学附属第一医院宫颈门诊行FISH检测的235例患者的临床资料,分析h TERC基因表达情况与宫颈细胞学及病理组织学病变程度的关系。分析行FISH检测后选择宫颈锥切手术治疗的61例患者的h TERC基因扩增情况与术后病理升级的关系。结果:随细胞学病变级别的进展,h TERC基因异常扩增率呈上升趋势(P<0.05)。随组织病理学级别的进展,h TERC基因扩增率及异常扩增率呈上升趋势(P<0.05)。h TERC基因异常扩增的患者其术后病理升级率明显高于h TERC基因未异常扩增患者(P<0.05)。结论:h TERC基因的表达水平随宫颈病变级别的升高而增加,h TERC基因异常扩增的患者其术后病理级别升级的可能性大,提示FISH技术检测宫颈脱落细胞中h TERC基因的表达情况对宫颈病变的发展趋势具有一定的预测价值。

Objective:To investigate the clinical significance of human telomerase RNA gene component(hTERC)detection in exfoliated cervical cells by fluorescence in situ hybridization(FISH)technique.Methods:hTERC gene amplification was tested by FISH in 235 patients at the First Affiliated Hospital of Wenzhou Medical University from December 2014 to October 2016.Retrospective analysis was made to explore the relationship between hTERC gene expression and the severity of histological and cytological abnormality.The association between hTERC gene amplification and postoperative pathological upgrade was analyzed in 61 patients who chose cervical conization surgery after FISH detection.Results:With the severity of cytological abnormality,hTERC gene abnormal amplification rate increased significantly(P<0.05).With the severity of histological abnormality,hTERC gene amplification rate and abnormal amplification rate increased significantly(P<0.05).The pathological upgrade rate after cervical conization surgery in patients with abnormal hTERC gene amplification rate was significantly higher than those with normal amplification rate(P<0.05).Conclusion:With the severity of cervical lesions,the expression of hTERC gene amplification rate increased.The pathological upgrade rate in patients with abnormal hTERC gene amplification rate was more likely to be higher than those with normal amplification rate.These results suggest that the hTERC gene detection with FISH technique has predictive value in the progression of cervical lesions.