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[目的]研究液基细胞学(TCT)、人乳头瘤病毒(HPV)检测及人类染色体端粒酶基因(hTERC)、C-myc基因检测在宫颈癌筛查中的临床应用价值。[方法]对1000例患者分别进行TCT、HPV-DNA检测、荧光原位杂交(FISH)技术检测hTERC、C-myc基因,对以上任一结果阳性者进行阴道镜下宫颈活检术,以病理学结果为金标准,评价上述方法的敏感度及特异性。[结果]1000例患者中,TCT异常者304例(30.4%);HPV阳性者273例(27.3%);hTERC阳性者90例(9.0%);C-myc阳性者59例(5.9%)。467例患者行阴道镜下宫颈活检术,结果宫颈慢性炎者244例,宫颈病变者223例,其中宫颈上皮内瘤变CINI73例(15.6%),CINⅡ87例(18.6%),CINⅢ53例(11.3%),宫颈鳞状细胞癌10例(2.1%)。hTERC基因在正常宫颈细胞、CINⅠ、CINⅡ、CINⅢ和宫颈癌中的阳性表达率分别为4.1%、16.4%、36.8%、50.9%和90%。C-myc在正常宫颈、CINⅠ、CINⅡ、CINⅢ和宫颈癌中的阳性表达率分别为1.6%、9.6%、21.8%、37.7%和90%。[结论]联合筛查方法优于单一检测方法,TCT+hTERC联合检测宫颈癌的效果最好,hTERC、C-myc基因异常扩增率随宫颈病变程度的加重而增加,与宫颈癌发生发展密切相关。
[Objective] To investigate the clinical value of detection of TCT, HPV and human telomerase reverse transcriptase (hTERC) and C-myc in cervical cancer screening. [Method] 1000 cases of patients were detected by TCT, HPV-DNA, fluorescence in situ hybridization (FISH) detection of hTERC, C-myc gene, positive for any of the above colposcopic colposcopy biopsy, pathology The result is the gold standard, evaluating the sensitivity and specificity of the above method. [Results] Of the 1000 patients, 304 (30.4%) had abnormal TCT, 273 (27.3%) had HPV positive, 90 (9.0%) had hTERC positive and 59 (5.9%) had positive C-myc. 467 patients underwent colposcopy cervical biopsy, results of chronic cervicitis in 244 cases, 223 cases of cervical lesions, including cervical intraepithelial neoplasia CINI in 73 cases (15.6%), CIN Ⅱ 87 cases (18.6%), CIN Ⅲ in 53 cases (11.3% ), Cervical squamous cell carcinoma in 10 cases (2.1%). The positive rates of hTERC gene in normal cervical cells, CINⅠ, CINⅡ, CINⅢ and cervical cancer were 4.1%, 16.4%, 36.8%, 50.9% and 90% respectively. The positive rates of C-myc in normal cervix, CINⅠ, CINⅡ, CINⅢ and cervical cancer were 1.6%, 9.6%, 21.8%, 37.7% and 90% respectively. [Conclusion] The combined screening method is superior to the single detection method, TCT + hTERC combined detection of cervical cancer the best, hTERC, C-myc gene abnormal amplification rate increases with the severity of cervical lesions increased, closely related with the occurrence of cervical cancer Related.