宫颈组织hTERC基因检测在宫颈癌筛查中的意义  

The significance of detection of genomic amplification of h TERC gene in cervical paraffin- embedded tissues in cervical cancer screening

作　　者：伍军平[1] 罗新[2] 王晓玉[2] 甘丹卉[3] 潘晓婷[3] 

机构地区：[1]广州市花都区妇幼保健院,广东广州510800 [2]暨南大学附属第一医院妇产科,广东广州510630 [3]暨南大学附属第一医院病理科,广东广州510630

出　　处：《中国计划生育和妇产科》2015年第4期36-39,F0003,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：卫生部医药卫生科技发展研究中心项目(项目编号:WKJ2007-3-001)

摘　　要：目的探讨宫颈组织人染色体端粒酶(human telomerase RNA component,h TERC)基因检测在宫颈癌筛查中的意义。方法收集2008年10月至2011年2月暨南大学附属第一医院166例宫颈石蜡标本,根据病理结果分为对照组18例(正常宫颈、慢性宫颈炎或鳞状上皮化生);宫颈上皮内瘤变(cervical imtrae pithelial neoplasia,CIN)Ⅰ组30例;CINⅠ-Ⅱ组28例;CINⅡ组35例;CINⅢ组35例;宫颈癌组20例,其中初治15例(鳞癌11例,腺鳞癌3例,腺癌1例),治疗后复发5例。应用荧光原位杂交(FISH)技术检测上述标本的h TERC基因表达情况,并与宫颈癌其他筛查方法进行比较。结果 (1)对照组、CINⅠ、CINⅠ-Ⅱ、CINⅡ、CINⅢ及宫颈癌组中h TERC基因扩增率分别为5.6%、10.0%、32.1%、65.7%、88.6%及95.0%。对照组和CINⅠ组h TERC基因扩增率均显著低于CINⅠ-Ⅱ、Ⅱ、Ⅲ级和宫颈癌组(均P<0.05);宫颈组织中h TERC基因的扩增率随着宫颈病变程度递增而逐渐增加(χ2=12.270,P<0.05)。(2)宫颈组织h TERC基因检测对预测宫颈高级别病变的灵敏度、特异度、准确度、阳性预测值、阴性预测值、阳性似然比、阴性似然比及约登指数分别为81.1%、79.3%、80.4%、85.9%、73.0%、3.92、0.24及0.60。结论宫颈组织中h TERC基因检测对宫颈高度病变具有较高的检出率。Objective To investigate the genomic amplification of human telomerase gene（ h TERC） in paraffin- embedded tissues of cervical intraepithelial neoplasia（ CIN） and cervical cancer（ CC） by fluorescence in situ hybridization（ FISH） in order to evaluate its clinical significance in cervical cancer screening. Methods The genomic amplification of h TERC gene in 166 cases of cervical paraffin- embedded tissues were delected by FISH collected The First Affiliated Hospital of Jinan University from October 2008 to February 2011. According to the histology biopsy,166 cases divided into the control group（ 18 cases of normal,chronic cervicitis or metaplasia of squamous epithelium） and the study groups（ 166 cases）,including CINⅠ（ 30 cases）,CINⅠ- Ⅱ（ 28 cases）,CINⅡ（ 35 cases）,CINⅢ（ 35 cases） and cervical cancer（ 20 cases）,of which 15 cases of initial treatment（ 11 cases of squamous cell carcinoma,3 cases adenosquamous carcinoma,and 1 case adenocarcinoma） and 5 cases of relapse after treatment. To detect the genomic amplification of h TERC gene in the paraffin tissues of each group by FISH,and compared with the results of cervical cytology,HPV- DNA detection,colposcopy. Results（ 1） The genomic amplification rate of h TERC gene in the control group,CIN Ⅰ,CINⅠ- Ⅱ,CIN Ⅱ,CIN Ⅲ and cervical cancer group were 5. 6%,10. 0%,32. 1%,65. 7%,88. 6% and 95. 0% respectively. The difference of h TERC genomic amplification between control group,CIN Ⅰ and CIN Ⅰ- Ⅱ,CIN Ⅱ,CIN Ⅲ,cervical cancer was statistically significant（ P〈0. 05）. The genomic amplification rate of h TERC increased with the degree of cervical lesion gradually increased（ χ2= 12. 270,P〈0. 05）.（ 2） The sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden index of the genomic amplification of h TERC in the paraffin specimens for predicting high- grade cervical lesions were 81. 1%,79. 3%,80. 4%

关 键 词：宫颈肿瘤 原位杂交 荧光 宫颈上皮内瘤样病变 人染色体端粒酶基因 

分 类 号：R711.74[医药卫生—妇产科学]