c-Myc、hTERC基因检测及HC2-HPV分子检测对宫颈癌前病变的诊断价值

The Diagnostic Value of c-myc,hTERT Gene Detection and HC2-HPV Molecular Detection in Cervical Lesions

目的研究宫颈病变组织中人髓细胞增生原癌基因(myelocytomatosis oncogene,c-Myc)和人端粒酶逆转录酶(human telomerase reverse transcriptase,hTERT)基因的表达情况及其与高危型HPV感染的相关性,以寻找高效的宫颈癌筛检策略。方法选取昆明医科大学第二附属医院妇科1200名行宫颈癌筛查患者,分别用荧光原位杂交(fluorescence in situ hybridization,FISH)技术行c-Myc、hTERC基因检测和杂交捕获II(hybrid captureⅡ,HC2)技术检测HPV感染情况,任意一项结果异常者(150例)行宫颈活检术。最后以病检结果分组,分析c-Myc、hTERT基因的诊断价值及其与HC2-HPV阳性率的关联性。结果随着宫颈病变的加重,c-Myc基因、hTERT基因表达几率及高危型HPV感染率均呈上升趋势(P<0.05);ROC曲线示HC2-HPV、c-Myc基因、hTERT基因单独筛查宫颈病变的AUC分别为0.699、0.677和0.687,灵敏度分别为91.3%、62.5%和58.8%,特异度分别为48.6%、72.9%和78.6%;Spearman相关分析示c-Myc基因、hTERT基因表达率与HC2-HPV感染率之间呈显著正相关(r1=0.576,P=0.000;r2=0.545,P=0.000)。结论c-Myc基因和hTERT基因与宫颈病变程度密切相关,二者可与HC2-HPV检测法联合筛检宫颈病变,对评估宫颈癌前病变具有重要意义。

Objective To study the medullary cell hyperplasia proto-oncogene(myelocytomatosis oncogene,c-Myc)and human telomerase reverse transcriptase(human telomerase reverse transcriptase,hTERT)gene expression in cervical lesion and its correlation with high risk type HPV infection,to find effective strategies of cervical cancer screening.Methods A retrospective selection of 1200 patients with cervical cancer screening was performed in the Department of Gynaecology,the Second Affiliated Hospital of Kunming Medical University.Fluorescence in situ hybridization(fluorescence in situ hybridization,FISH)technical line for c-Myc,hTERC gene detection and hybrid capture Ⅱ(hybrid captureⅡ,HC2)technology was used to detect HPV infection status.The cases with any of the abnormalresult were given cervical biopsy(150 cases).Finally,the diagnostic value(sensitivity,specificity,etc.)of c-myc and hTERT genes and their correlation with the positive rate of hc2-hpv were analyzed by grouping the disease detection results.Results With the aggravation of cervical lesions,the expression rate of C-MYC gene,hTERT gene and the infection rate of high-risk HPV all showed an increasing trend(P<0.05).The AUC of hC2-HPV,C-MYC and hTERT genes were 0.699,0.677 and 0.687,the sensitivity were 91.3%,62.5%and 58.8%,and the specificity were48.6%,72.9%and 78.6%.Spearman correlation analysis showed that c-MYC gene and hTERT gene expression rate were significantly positively correlated with HC2-HPV infection rate(r1=0.576,P=0.000;r2=0.545,P=0.000).Conclusion C-myc gene and hTERT gene are closely related to the degree of cervical lesions,and they can be combined with hc2-HPV detection to screen cervical lesions,which is of great significance for the assessment of cervical precancerous lesions.