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目的:探讨宫颈病变脱落细胞中人类染色体端粒酶基因(hTERC)的表达及hTERC基因检测在宫颈癌筛查中的临床意义。方法:收集宫颈病变患者的宫颈脱落细胞标本129例,依据组织病理学结果分为3组:宫颈上皮内瘤变低度病变组(CINⅠ)、高度病变组(CINⅡ/Ⅲ)、宫颈癌组(SCC);同时选择健康妇女的宫颈脱落细胞标本20例作为对照组建立实验室阈值;应用荧光原位杂交技术(FISH)检测两组标本hTERC基因的扩增情况,最终以病理学诊断为金标准,比较FISH检测结果。结果:研究各组中CINⅠ,CINⅡ/Ⅲ,SCC的hTERC基因阳性表达率分别为7.31%,56.25%,75.00%,hTERC基因扩增比例随病变进展而增加;研究组与对照组hTERC基因阳性表达率差异有统计学意义(P<0.05);研究各组两两比较,hTERC基因阳性表达率低度病变组与高度病变组、宫颈癌组差异有统计学意义(P<0.05),而高度病变组与宫颈癌组的差异无统计学意义(P>0.05)。结论:FISH方法检测hTERC基因可用于筛查宫颈高度病变及宫颈癌,其阳性扩增信号多倍体型可能是宫颈病变进展的预测性指标。
Objective: To investigate the expression of human chromosome telomerase gene (hTERC) in cervical exfoliated cells and the clinical significance of hTERC gene detection in cervical cancer screening. Methods: 129 cases of cervical exfoliated cells from patients with cervical lesions were collected and divided into 3 groups according to histopathological results: CINⅠ, CINⅡ / Ⅲ, SCC). At the same time, 20 cases of cervical exfoliated cells from healthy women were selected as the control group to establish the laboratory threshold. The amplification of hTERC gene in both groups was detected by fluorescence in situ hybridization (FISH), and finally the pathological diagnosis was the gold standard , Compare FISH test results. Results: The positive expression rate of hTERC gene in CINⅠ, CINⅡ / Ⅲ and SCC was 7.31%, 56.25% and 75.00% in each group, and the hTERC gene amplification ratio increased with the progression of the disease. The expression of hTERC gene in study group and control group was positive There was significant difference between the two groups (P <0.05). There was a significant difference in the expression of hTERC gene between the low-grade group and the high-grade group and the cervical cancer group (P <0.05) There was no significant difference between group and cervical cancer (P> 0.05). Conclusion: The FISH method can detect hTERC gene for screening of cervical lesions and cervical cancer. The polyploidy of positive amplification signal may be the predictive index of cervical lesions.