宫颈上皮内瘤变治疗前后hTERC基因表达结果分析  

Analysis of hTERC Gene Expression before and after Treatment in Cervical Intraepithelial Neoplasia

作　　者：杨维娜[1] 尹利荣[1] 段青[1] 马鸿达[1] 

机构地区：[1]天津医科大学第二医院妇产科,300211

出　　处：《天津医药》2010年第8期654-656,共3页Tianjin Medical Journal

基　　金：天津医科大学第二医院科研基金资助项目(项目编号:y0704)

摘　　要：目的:探讨hTERC基因在宫颈上皮内瘤变(CIN)中治疗前后的表达情况及其在宫颈CIN治疗中的价值。方法:经阴道镜下多点活检CINⅠ和Ⅱ级患者共30例行宫颈环形电切除术(LEEP)治疗,CINⅢ级患者4例行子宫颈锥切术。于手术治疗前及治疗后6个月应用荧光原位杂交(FISH)技术检测宫颈脱落细胞hTERC基因的表达并行薄层液基细胞学检测(TCT)、人乳头瘤病毒(HPV)检测,应用FISH技术评估LEEP在手术治疗CIN中的价值。结果:(1)CIN随组织学病变程度的加重,hTERC基因表达百分比逐渐升高(均P<0.05)。治疗后发生hTERC基因表达的细胞数,平均每例所占百分比较治疗前明显降低(P<0.01)。(2)治疗后病变残留者多为hTERC基因表达强阳性者,而弱阳性及中等阳性表达者均无病变残留,差异有统计学意义(P<0.05)。结论:hTERC基因异常扩增可能是宫颈癌形成的早期事件,检测hTERC基因的表达有助于判断CIN的治疗效果,且对预测病变残留有重要价值。Objective： To detect the expression of hTERC gene in cervical intraepithelial neoplasia（CIN）before and after treatment,and the clinical significance in CIN therapy. Methods： A series of 34 CIN patients including 14 CINⅠ, 16 CINⅡ and 4 CINⅢ, who were preliminarily diagnosed by biopsy under the colposcopy. Total of 30 patients （14 CINⅠand 16 CINⅡ） were subjected to the loop electrosurgical excision procedure （LEEP）. Four patients of CINⅢ were subjected to conization of cervix. The expressions of hTERC gene applying fluorescence in situ hybridization （FISH）, human papillomaviral infection （HPV） and thinprep cytology test （TCT）were detected in all patients before operation. All patients were followed-up for 6 months. The patients were detected by FISH,HPV,TCT and biopsy under the colposcopy 6 months after treatment. The possibility and validity of FISH in detecting and forecasting residual CIN were evaluated. Results： （1）In all CIN groups, the percentage of cells with amplification of hTERC gene increased with the severity of the histological interpretation （P 0.05）. The percentage of cells with amplification of hTERC gene was obviously lower than that of prior treatment （P 0.01）. The positive expression of hTERC gene was major in prior treatment group, and the negative expression was major in post-treatment group, the difference was significant （P 0.01）. （2）After treatment, residual lesions were mostly hTERC strong positive expression, and weak positive and moderate positive expression had no residual disease （P 0.05）. Conclusion： The abnormal amplification of hTERC gene is the early incident in the process of forming cervical cancer. There is an important value in detecting hTERC gene before and after therapy to determine the effect of the CIN treatment. It is also important in predicting the risk of residual disease by detecting the expression of hTERC gene.

关 键 词：宫颈上皮内瘤样病变 活组织检查 端粒 末端转移酶 原位杂交 荧光 细胞诊断学 α乳头状瘤病毒属 

分 类 号：R737.33[医药卫生—肿瘤]