hTERC基因检测对筛查高危子宫颈病变预防宫颈癌的临床意义  

Clinical significance of hTERC gene examination in cervical tissue for screening of high-risk cervical lesion and prevention

作　　者：史佃云[1] 陈赛英[1] 李桂梅[2] 

机构地区：[1]解放军八一医院妇产科,南京210002 [2]解放军八一医院病理科,210002

出　　处：《临床肿瘤学杂志》2011年第11期979-983,共5页Chinese Clinical Oncology

摘　　要：目的探讨应用荧光原位杂交(FISH)技术检测人染色体端粒酶RNA组分(hTERC基因)异常扩增在子宫颈病变中的临床意义。方法收集经组织病理学确诊的子宫颈病变组织245例,包括单纯性子宫颈炎75例、CINⅠ64例、CINⅡ63例和CINⅢ43例,另取20例健康宫颈组织作对照。用FISH方法检测265例宫颈活检组织的hTERC基因表达,用表面等离子体谐振核酸检测法对其中196例进行HPV-DNA检测。结果正常宫颈组织hTERC基因的异常扩增检出率为0,宫颈炎、CINⅠ、CINⅡ和CINⅢ组织分别为2.7%(2/75)、9.4%(6/64)、61.9%(39/63)和62.8%(27/43)。正常宫颈组织HPV阳性率为10.0%(1/10),宫颈炎、CINⅠ、CINⅡ组织分别为10.8%(7/65)、25.0%(11/44)和29.8%(14/47),而CINⅢ组织则高达63.3%(19/30),差异有统计学意义(P<0.05)。同时有hTERC基因异常扩增和HPV阳性的检出率在CINⅢ组织中为50.0%,显著高于CINⅡ的27.7%和CINⅠ的2.3%(P<0.05),未见于正常宫颈和宫颈炎;hTERC基因异常扩增的检出率在HPV阳性人群为55.8%(29/52),显著高于HPV阴性人群的18.1%(26/144),差异有统计学意义(P<0.05)。对宫颈病变高危性的诊断,hTERC基因异常扩增检测的敏感性为63.6%,优于HPV检测的39.0%(P<0.05)。71例CINⅡ、CINⅢ高危患者行宫颈锥切治疗,取切缘正常组织检测,hTERC基因呈阴性,术后经4个月～2年随访追踪,病灶修复部位未见有hTERC基因转为阳性。结论 hTERC基因检测有助于筛查宫颈高危病变和选择治疗方案,对预防宫颈癌有益;同时进行hTERC基因联合HPV检测将更有意义。Objective To investigate the clinical significance of human telomerase RNA component（hTERC） examination in uterine cervical tissue for screening high-risk cervical lesion and prevention. Methods The abnormal amplification of hTERC gene in cervical tissue samples from 265 cervical tissues was determined by using interphase fluorescence in situ hybridization（FISH）.According to the histology and pathology biopsy,265 samples were divided into 5 groups： normal control group（from 20 healthy women）,simple cervicitis group（n=75）,cervical intraepithelial neoplasia（CIN） grade Ⅰ group（n=64）,CIN grade Ⅱ group（n=63）,and CIN grade Ⅲ group（n=43）,respectively.Detection for human papillomavirus（HPV） infection was performed in 196 of 265 samples by SPR. Results（1）None was revealed abnormal amplification of hTERC in normal control group,while 2.7%（2/75） in cervicitis,9.4%（6/64） in CIN Ⅰ group,61.9%（39/63） in CIN Ⅱ group and 62.8%（27/43） in CIN Ⅲ group were found abnormal amplification of hTERC gene.（2）In 196 samples,which were also detected for HPV infection,HPV positive rate was 10.0% in normal control group（1/10）,10.8% in cervicitis（7/65）,25.0% in CIN Ⅰ group（11/44）and 29.8% in CIN Ⅱ group（14/47）,respectively,while 63.3% in CIN Ⅲ group（19/30）,the difference was statistically significant（P〈0.05）.Double positive case of hTERC abnormal amplification and HPV infection was 50.0% in CIN Ⅲ group,which was significantly higher than that in CIN Ⅱ group（27.7%） and in CIN Ⅰ group（2.3%）（P〈0.05）,while none was found in normal control and cervicitis groups.The abnormal amplification rate of hTERC gene was 55.8%（29/52） in HPV infection population,which was significantly higher than that in HPV negative population（18.1%,26/144）,showing significant differences（P〈0.05）.（3） The sensitivity of hTERC test to high-grade intraepithelial lesion（63.6%） was higher than that of HPV test（39.0%）,showing signi

关 键 词：HTERC基因 人乳头瘤病毒 宫颈上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]