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目的:探讨端粒酶催化亚单位(hTERT)在不同程度宫颈病变组织中的表达及其与临床病理特征的关系。方法:收集不同程度宫颈病变石蜡组织标本共236例,其中宫颈炎41例、CINⅠ级45例、CINⅡ级42例、CINⅢ级41例、宫颈鳞状细胞癌39例、腺癌28例。采用免疫组化SP法检测不同程度宫颈病变组织中hTERT蛋白表达,并将结果与患者临床病理特征结合分析,探讨hTERT表达与临床病理特征的关系。结果:在宫颈炎、CINⅠ、CINⅡ、CINⅢ、宫颈鳞状细胞癌、腺癌组织中hTERT表达阳性率分别为0.00%(0/41)、2.22%(1/45)、7.14%(3/42)、39.02%(16/41)、92.31%(36/39)、92.86%(26/28),组间比较差异有统计学意义(P<0.05),CINⅠ与CINⅡ之间hTERT表达阳性率不存在统计学差异(P>0.05),而CINⅠ与CINⅢ、CINⅡ与CINⅢ之间hTERT表达阳性率存在统计学差异(P<0.05);鳞癌、腺癌组中高、中、低分化三组间hTERT表达阳性率差异均无统计学意义(P>0.05)。hTERT蛋白的表达与高危型HPV感染、宫颈肿瘤家族史呈正相关(P<0.05),但与年龄、性生活开始年龄、性伴侣人数、人工流产次数、吸烟、避孕方法选择等高危因素无相关性(P>0.05)。结论:hTERT表达的检测有可能成为宫颈病变发展及宫颈癌的诊断及鉴别诊断的一种新指标,但不一定参与肿瘤分化和生物学特性。
Objective: To investigate the expression of telomerase catalytic subunit (hTERT) in different degree of cervical lesions and its relationship with clinicopathological features. Methods: A total of 236 paraffin - embedded specimens of cervical lesions were collected, including 41 cases of cervicitis, 45 cases of CIN Ⅰ grade, 42 cases of CIN Ⅱ grade, 41 cases of CIN Ⅲ grade, 39 cases of cervical squamous cell carcinoma and 28 cases of adenocarcinoma. Immunohistochemical SP method was used to detect the expression of hTERT protein in different degree of cervical lesions, and the results were combined with the clinicopathological features of patients to explore the relationship between hTERT expression and clinicopathological features. Results: The positive rates of hTERT in cervicitis, CINⅠ, CINⅡ, CINⅢ, cervical squamous cell carcinoma and adenocarcinoma were 0.00% (0/41), 2.22% (1/45) and 7.14% (3/42 ), 39.02% (16/41), 92.31% (36/39) and 92.86% (26/28) respectively. There was significant difference between the two groups (P <0.05). The positive rate of hTERT expression between CINⅠand CINⅡwas not significant (P> 0.05). However, the positive rates of hTERT expression between CINⅠ and CINⅢ, CINⅡ and CINⅢ were significantly different (P <0.05). The expression of hTERT in high, moderate and poorly differentiated squamous cell carcinoma There was no significant difference in the positive expression rate (P> 0.05). The expression of hTERT protein was positively correlated with high risk HPV infection and family history of cervical cancer (P <0.05), but not with age, risk of onset of sexual life, number of sexual partners, number of induced abortions, choice of smoking and contraceptive methods (P> 0.05). Conclusion: The detection of hTERT expression may become a new indicator of cervical lesions and cervical cancer diagnosis and differential diagnosis, but not necessarily involved in tumor differentiation and biological characteristics.