hTERC和高危HPV及细胞学联合检测在宫颈癌筛查中的价值 |
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引用本文: | 柳晓春,邓凯贤,郑玉华,彭敏,周东华,谢庆煌,潘淑芬.hTERC和高危HPV及细胞学联合检测在宫颈癌筛查中的价值[J].四川肿瘤防治,2014(1):12-15,23. |
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作者姓名: | 柳晓春 邓凯贤 郑玉华 彭敏 周东华 谢庆煌 潘淑芬 |
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作者单位: | 广东省佛山市妇幼保健院,广东佛山528000 |
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摘 要: | 目的:探讨联合应用hTERC、高危HPV检测及液基细胞学检查TCT在宫颈癌筛查中的意义。方法:选择2010年5月至2012年1月因宫颈异常在佛山市妇幼保健院宫颈门诊行TCT检查的患者100例为研究对象,同时行HC2检测高危HPV感染,FISH技术检测hTERC基因扩增及阴道镜下病理活组织检查,以病理学结果为金标准,将三种检测方法的结果与其进行比较。结果:非CIN组、CIN1、高级别CIN及浸润癌中TCT检查与病理学结果符合率分别为88.9%(16/18)、58.33%(14/24)、68.29%(28/41)、76.47%(13/17),高危HPV阳性率分别为27.78%(5/18)、91.67%(22/24)、97.56%(40/41)、100%(17/17),hTERC阳性率分别为11.1%(2/18)、29.17%(7/24)、87.80%(36/41)、100%(17/17)。随着宫颈病变病理级别的递增,高危HPV的表达及hTERC基因扩增出现递次增高。非CIN组高危HPV感染率低于CIN组,差异有统计学意义(P〈0.01),CIN1、CIN2及CIN3三组间比较差异无统计学意义(P〉0.05),CIN组与宫颈浸润癌组差异无统计学意义(P〉0.05)。hTERC基因扩增率高级别CIN组及浸润癌组明显高于低级别CIN1组(P〈0.01)。结论:在宫颈癌筛查中,细胞学检查具有较高的特异性(92.5%),但灵敏度较差(53.4%),高危HPV检测灵敏度高(96.7%),但特异性差(44.6%),hTERC基因扩增筛查高级别CIN病变特异性高(98.6%),灵敏度稍低(71.7%),在宫颈组织的表达率与宫颈病变程度密切相关,三种方法联合检测可以大大提高宫颈癌前病变的阳性检出率,有利于较特异地识别出具有较高的转化为宫颈癌潜能的高级别CIN病变。
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关 键 词: | 端粒末端转移酶 高危型人乳头瘤状病毒 液基细胞学 宫颈癌 宫颈上皮内瘤样病变 |
Significance of Co-testing of Genomic Amplification of the Human Telomerase RNA Component Gene,High Risk Human Papilloma Virus Detection and Liquid-based Cytological Test for Cervical Cancer Screening |
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Institution: | Liu Xiaochun, Deng Kaixian, Zheng Yuhua, et al (Maternal and Children' s Hospital of Foshan Guangdong, Foshan 528000, Guangdong, China) |
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Abstract: | Objective: To investigate the significance of unite apply of genomic amplification of the human telom- erase RNA component (hTERC) gene and high risk hmnan papilloma virus detection and fiquid-based cytological test for the screening of cervical cancer. Methods: From May 2010 to Jan. 2012,100 specimens were obtained from patients with cervical problems in our hospital. The specimens were evaluated by the Digene Hybrid Capture 2 ( HC2 ) HPV DNA test and fluorescence in situ hybridization (FISH) with a chromosome probe to TERC and thinprep liquid based cytology test ( TCT ). At the same time, Histological evaluations were performed, The results of these 3 methods were compared with the results of histological evaluation. Results : In the normal, cervical intraepithelial neoplasia grade 1 ( CIN1 ), grade 2 (CIN2), grade 3 (CIN3) and squamous cervical cancer (SCC) cases, the coincidence rate of TCT and histological evalu- ation were 88.9% ( 16/18), 58.33% (14/24) ,68.29% (28/41) ,76, 47% (13/17) respectively. The HR-HPV posi- tive rates were 27.78% (5/18) ,91.67% (22/24), 97.56% (40/41), 100% ( 17/17 )respectively. The positive rate of HR-HPV DNA in CIN was higher than that in the normal group(p 〈 0.01 ) and statistics difference was neither found among CIN groups ( P 〉 0. 05 ) nor between CIN and SCC groups(P 〉0.05). The amplification of hTERC was higher in higher grade cervical diseases and its positive rates were higher in the CIN2 + (CIN2, CIN3 and SCC) group than in the normal and CIN 1 groups (p 〈 0. 01 ). Conclusion: Liquid-based cytology is the most often used method for cervical cancer screening. It is specific(92.5% ) but relatively insensitive(53.4% ) and frequently gives equivocal results. HR-HPV DNA test is highly sensitive(96.7% ) but not very specific(44.6% ). The TERC amplification test has higher specificity(98. 6% )and lower sensitivity(71.7% ) , it can easily identify high grade CIN. hTERC and HPV DNA and TCT co-testing shows an optimal combination of sensitivity and specificity for cervical cancer screening as well as can identify high grade CIN. |
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Keywords: | Human Telomerase RNA Component High Risk Human Papilloma Virus Thinprep Liquid Based Cytology Test Cervical Cancer CIN |
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