CA19-9与hTERC基因联合检测在宫颈上皮内瘤变诊断中的价值

目的探讨血清糖类抗原19-9(CA19-9)联合人端粒酶RNA基因(hTERC)在诊断宫颈上皮内瘤变中的价值。方法选取2010年1月至2014年11月右江民族医学院附属医院妇科门诊采集的392例宫颈脱落细胞标本作为研究对象,利用全自动酶免疫分析系统测定血清CA19-9的变化水平,荧光原位杂交(FISH)方法检测hTERC基因的表达水平。结果 CA19-9的总体阳性率38.78%(152/392);hTERC的总体阳性率26.79%(105/392);HPV检测阳性率64.54%(253/392);χ2趋势检验显示,随着宫颈病变病理级别的升高,CA19-9和hTERC阳性率均呈现逐步上升的趋势(χ2CA19-9=-4.089,P0.05;χ2hTERC=7.795,P0.05);Spearman分析结果显示,CA19-9水平和hTERC基因表达均与宫颈病变的程度呈正相关关系(rCA19-9=0.308,P0.05;rhTERC=0.256,P0.05);CA19-9水平的检测灵敏度71.64%,hTERC基因的检测灵敏度65.67%,CA19-9联合hTERC基因的检测灵敏度则可达92.54%,联合检测策略的灵敏度明显高于单独CA19-9或hTERC基因检测(χ2CA19-9=6.292,P0.05;χ2hTERC=5.121,P0.05);CA19-9和hTERC基因检测有4种类型结果,分别是:CA19-9(+)/hTERC(+)、CA19-9(+)/hTERC(-)、CA19-9(-)/hTERC(+)和CA19-9(-)/hTERC(-)。检测结果 CA19-9(+)/hTERC(+)的构成比随宫颈病变级别的增高而逐渐增加(P0.05)。结论 CA19-9联合hTERC检测有助于提高宫颈上皮内瘤变诊断的灵敏度。

Study on the value of detection of human telomerase RNA component gene combined with CA19-9 in the diagnosis of cer-vical intraepithelial neoplasia

Objective To explore the combination of serum carbohydrate antigen 19‐9(CA19‐9)and human te‐lomerase RNA component gene(hTERC)in the clinical diagnosis of cervical intraepithelial neoplasia .Methods Total‐ly 392 samples of cervical exfoliated cells were selected as the research object from January 2010 to November 2014 in the hospital .The level of serum CA19‐9 was detected by using full automatic enzyme immunoassay system ,and the expression of hTERC was evaluated by fluorescence in situ hybridization(FISH) .Results The total positive rate of CA19‐9 was 38 .78% (152/392);the total positive rate of hTERC was 26 .79% (105/392);the total positive rate of HPV was 64 .54% (253/392);Chi square trend test showed that ,with the increase of pathological grade of cervical lesions ,the positive rate of CA19‐9 and hTERC showed a gradual upward trend(χ2CA19‐9 = -4 .089 ,P<0 .05 ;χ2hTERC =7 .795 ,P<0 .05);Spearman analysis showed that ,CA19‐9 level and hTERC gene expression were positively correla‐ted with the degree of cervical lesions(rCA19‐9 =0 .308 ,P<0 .05;rhTERC =0 .256 ,P<0 .05);The detection sensitivity of CA19‐9 was 71 .64% ,the sensitivity of detection of hTERC gene was 65 .67% ,but the sensitivity of CA19‐9 and hTERC genes was 92 .54% ,sensitivity of the joint detection was significantly higher than that of single CA19‐9 or hTERC gene detection(χ2CA19‐9 =6 .292 ,P<0 .05 ;χ2hTERC =5 .121 ,P<0 .05);There were four types of results on the detection of CA19‐9 and hTERC genes ,CA19‐9(+ )/hTERC(+ ) ,CA19‐9(+ )/hTERC(-) ,CA19‐9(-)/hTERC (+ )and CA19‐9(-)/hTERC (-) ,respectively .The constituent ratio of CA19‐9 (+ )/hTERC (+ )also increased with the level of cervical lesions increased gradually(P<0 .05) .Conclusion CA19‐9 combined with hTERC may help to improve the sensitivity of diagnosis on the cervical intraepithelial neoplasia .