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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(human telomerase RNA component,hTERC)的表达及人乳头瘤病毒(human papillomavirus,HPV)亚型感染情况,及其在宫颈癌筛查中的意义。方法宫颈病变患者宫颈脱落细胞标本129例,依据组织病理学结果分为宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)I组41例、CINⅡ组29例、CINⅢ组35例及宫颈癌组(SCC组)24例,并选择同期体检健康者20例为对照组,各组均行宫颈液基细胞学检查及HPV DNA检测,并采用荧光原位杂交技术检测hTERC基因扩增情况。结果 hTERC表达阳性率CINⅠ组(7.31%)、CINⅡ组(34.48%)、CINⅢ组(62.86%)及SCC组(75.00%)与对照组(0)比较差异均有统计学意义(P<0.05),CINⅢ组与SCC组高于CINⅠ组(P<0.05);hTERC表达阳性率与宫颈病变程度呈正相关(r=0.931,P=0.031);对照组、宫颈癌前病变组(CINⅠ组+Ⅱ组+Ⅲ组)与SCC组HPV DNA阳性率分别为15.00%,45.71%,87.50%,差异有统计学意义(P<0.05);hTERC表达与高危型HPV感染呈正相关(r=0.381,P=0.002)。结论 hTERC扩增在宫颈高度病变及宫颈癌患者中比例较高,与高危型HPV感染有关,可能是宫颈癌进展的预测性指标。
Objective To investigate the expression of human telomerase RNA (hTERC) gene and the infection of human papillomavirus (HPV) in cervical exfoliated cells and its significance in cervical cancer screening. Methods A total of 129 cervical exfoliated cells from patients with cervical lesions were divided into four groups according to their histopathological findings, including 41 cases of cervical intraepithelial neoplasia (CIN) group I, 29 cases of CINⅡ group, 35 cases of CINⅢ group and cervical cancer group SCC group). Twenty healthy subjects were selected as the control group in the same period. All patients underwent cervical liquid-based cytology and HPV DNA detection. Fluorescence in situ hybridization was used to detect the amplification of hTERC gene. Results The positive rate of hTERC expression was significantly higher in CINⅠgroup than in control group (7.31%), CINⅡgroup (34.48%), CINⅢgroup (62.86%) and SCC group (75.00%) (P <0.05) (P <0.05). The positive rate of hTERC expression was positively correlated with the degree of cervical lesions (r = 0.931, P = 0.031). In the control group, cervical precancerous lesions group (CINⅠ + Ⅱ group) + Ⅲ group) and SCC group were 15.00%, 45.71%, 87.50% respectively, the difference was statistically significant (P <0.05); hTERC expression was positively correlated with HPV infection of high risk type (r = 0.381, P = 0.002 ). Conclusion The hTERC amplification in cervical lesions and high incidence of cervical cancer patients with high risk HPV infection, may be predictive of cervical cancer progress.