宫颈脱落细胞hTERC基因扩增在宫颈病变筛查中的应用与意义

目的探讨FISH(原位荧光杂交)技术在宫颈病变筛查中的意义。方法应用FISH技术检测正常女性45名,宫颈异常病变患者208例宫颈脱落细胞hTERC(人端粒酶)基因的扩增,并通过与病理检查结果和液基薄层形态结果的对比分析FISH技术在宫颈病变筛查中的应用与意义。结果在生理盐水涂片、直接涂片标本和TCT(液基薄层)三种可选标本中,以TCT低渗制片操作方法简单快速,玻片背景最为清晰,杂交成功率最高。以TCT分组的受试者中,正常组、ASC组、LSIL组、HSIL组、SCC组分别为2.2%(1/45)、4.8%(2/41)、73.0%(84/115)、95.2%(20/21)、100%(31/31);以病理活检分组的受试者中,正常者组、炎症者组、CINⅠ组、CINⅡ期组、CINⅢ期组、SCC组分别为2.2%(1/45)、4.8%(2/41)、70.5%(31/44)、82.5%(33/40)、100%(21/21)、100%(31/31);在CINⅠ期、CINⅡ期、CINⅢ期、SCC组中hTERC基因扩增杂交信号≥3∶3型的异常细胞数占总异常细胞数的百分比分别为26.0%、52.1%、65.9%、90.7%,呈渐进上升趋势。结论 FISH检测宫颈脱落细胞hTERC基因扩增,以TCT低渗制片法最简便实用;宫颈脱落细胞中hTERC基因的异常扩增随着宫颈病变程度的加深呈现趋势性上升,FISH检测hTERC基因扩增可望成为宫颈病变筛查新的措施。

Genomic Amplication and Screening Significance of the hTERC in Cytological Samples of Cervical Lesions

Objective To disclose hTERC gene amplification in TCT(thin prepcytologic test) slides for predication development of cervical lesions.Methods TCT samples of cervix including 45 normal women,34 Inflamation,148 CIN(cervical intreapithelial neoplasia) patients and 26 SCC(squamou carcinomas of cervix)patients were detected by a commercially available triple-color FISH(fluorescence in situ hybridization)probe set.Data was evaluated by statistics.Results hTERC expression positeve rates in normal women,Inflamation,CIN1,CIN2,CIN3 and SCC patients were 2.2%(1/45),4.8%(2/41),57.1%(32/56),88.1%(52/59),95.2%(20/21),100%(31/31) respectively.Compared with normal/ Inflamation group,TERC expression positeve rates in CIN/SCC group were significantly different(P<0.01),and there were also difference between CIN1/CIN2 group and CIN3/SCC group(P<0.05).Along of progression from CIN to SCC,high hTERC gene copy numbers ascended obviously.Among the total aberrant cells,the percentage with more than 3:3 hTERC amplification signals in CIN1、CIN2、CIN3 and SCC groups were 26.0%、52.1%、65.9% and 90.7% respectively.Conclusion When detecting the TERC gene by dual-color interphase FISH,the hypotonic thin-layer slides approaches get the highest hybridization rates and backgroud-clearness rates.It is suitable for cytological analysis of the cervical cells.The TERC is in pace gained with Cervical Lesions from normal to SCC and appear to be another screening biomarker for early cervical cancer screening compared with TCT.