摘要
目的:探讨应用FISH(荧光原位杂交)技术检测不同程度宫颈病变中人类染色体末端酶基因(hTERC基因)的扩增情况,为宫颈癌的筛查、早期诊断及预后评估提供新的途径。方法:收集2009-01～2010-06来珠海市第二人民医院门诊就诊病人的宫颈脱落细胞标本148例,按细胞学检查结果分为:未见上皮内瘤变(NILM)35例、未明确诊断意义的不典型鳞状细胞(ASC-US)34例、不除外高度上皮内病变的不典型鳞状细胞(ASC-H)9例、低度鳞状上皮内病变(LSIL)38例、高度鳞状上皮内病变(HSIL)22例和鳞状细胞癌(SCC)10例;组织学分组包括正常或慢性宫颈炎20例、宫颈上皮内瘤变(CIN)Ⅰ级75例、CINⅡ/Ⅲ级42例和SCC11例。用荧光原位杂交(FISH)方法检测宫颈脱落细胞中hTERC基因的扩增。结果:在细胞学分组中,hTERC基因扩增阳性率在NILM、ASCUS、LSIL、ASC-H、HSIL和SCC中分别为5.71%、17.60%、22.22%、44.70%、68.18%、100%;在组织学分组中,其hTERC基因扩增阳性率在正常或慢性宫颈炎、CINⅠ、CINⅡ/Ⅲ和SCC中分别为5%、9.33%、54.80%、100%。随细胞学和组织学病变程度增加,hTERC基因扩增阳性率均增加(P<0.001)。hTERC基因在HR-HPV阳性与阴性组中扩增率为30.33%与12.24%,两组比较有显著性差异(P<0.05)。hTERC基因检测CINⅡ/Ⅲ以上病变的敏感度、特异度、阳性预测值和阴性预测值分别为64.15%、95.63%、82.93%和82.24%。结论:FISH检测hTERC基因的阳性表达率随宫颈病变程度的加重而增加,hTERC基因扩增与宫颈细胞学和组织学异常密切相关,且随着病变程度增加其扩增阳性率增加,具有敏感性、特异性高的特性,诊断价值更高;FISH检测hTERC基因可作为预测宫颈病变进展到宫颈癌的生物遗传学标志物。从而弥补目前宫颈癌筛查程序中的不足,既宫颈癌前病变是否进展。应用FISH技术能早期发现与宫颈癌有关的基因变化,为基因诊断和个体化治疗开辟新的途径。
Objective:To explore the amplifiation of hTERC gene in decting varging degress cervical Lesions,provide new ways for the screening early diagnosis and prognosis for cervical cancer. Methods:Collect 148 patients' cervical cast - off cells who see a doctor to the second people's hospital in Zhuhai from 2009 -01～2010 -06.According to It's cytology,divide into:35 NILM,34 ASC - US,9 ASC - H,38 LSIL,22 HSIL and 10 SCC,classfy by histology,including 20 normal or chronic cervicitis,75 CIN,42CINⅡ/Ⅲand 11 SCC.To detect the amplification of hTERC gene about cervical cast - off cells by using FISH method.Results:According to the cytology classification,the positive rate of the amplification about hTERC gene in NILM,ASCUS,LSIL,ASC - H,HSIL and SCC each are 5.71%,17.60%,22.22%,44.70%,68.18%,100%.According to the histology classification, the positive rate of the amplification about hTERC gene in normal or chronic cervicitis,CINⅠ,CINⅡ/Ⅲand SCC each are 5%,9.33%,54.80%,100%.Along with the increasing lesion level,the positive rate of the amplification about hTERC gene are increasing too without exception(P<0.001).The amplification rate about hTERC gene in HR - HPV positive group and negative group each are 30.33%and 12.24%.This two group have significance differences(P<0.05).The hTERC gene to detect above CINⅡ/Ⅲlesion's sensitivity,specificity,positive predict value and negative predict value each are 64.15%,95.63%,82.93%and 82.24%.Conclusion:Adapt to the increasing lesion level,the positice rate of the amplification about hTERC gene are increasing too. The amplification of hTERC gene are closely related to the cervical cytology and histology,and with the increasing lesion degree,Its positive rate is increasing too,has the features of high sensitiveness and specificity.More value for the diagnose.The use of FISH to detect hTERC gene can serve as the maker of Biogenetics which can predict the evolution of cervical cancer,thus remedy the shortage of screening for cervical cancer.By using the FISH technology can discovery the gene changes which relevant to the cervical cancer earlier,and find new ways for gene diagnose and individual therapy.
出处
《内蒙古医科大学学报》
2010年第S4期4-8,共5页
Journal of Inner Mongolia Medical University
