应用FISH技术检测宫颈脱落细胞中hTERC基医扩增的临床意义

目的：研究荧光原位杂交技术在检测宫颈脱落细胞中hTERC基因扩增情况，为女性子宫颈病变的筛查、早期诊断及预后提供新途径。方法：收集60例妇女患者进行宫颈脱落细胞的液基细胞学检查（TCT）、第2代杂交捕获法（HC2）高危型人乳头瘤病毒（HPV）检测（HPV—DNA）、FISH法hTERC基因检测及经阴道镜下宫颈活检病理证实，做出宫颈病变的最后诊断。结果：随着细胞学病变程度的加重及宫颈上皮内瘤变（CIN）级别增加，hTERC基因扩增阳性率增加（χ^2=11．111，χ^2=10．824，P〈0．05）；HPV感染率随着细胞学病变程度的加重而升高（χ^2=6．570，P〈0．05）；HPV阳性患者中hTERC扩增明显高于HPV阴性患者（χ^2=38．723，P〈0．05）。结论：hTERC基因扩增与宫颈细胞学和组织学密切相关，通过hTERC基因是否扩增可以很好区分低度与高度病变，hTERC基因的扩增可能是HPV感染致端粒酶活性增加的早期事件。

Clinical significance by application of FISH to detect the amplification of hTERC gene in cytological specimens of cervix

Objective： To investigate hTERC gene amplification using FISH in cytological specimens of the cervix and provide a new way in screening cervical lesions, early dignosis, prognosis for female. Methods： The hTERC gene was detected by FISH in 60 samples and was confirmed pathologicaly by cervical biopsy using colposcopy after liquid-based cervical cytology of cervical exfoliated cells（TCT）, high risk HPV-DNA detection by HC-II. Results： hTERC gene amplification positive rate was raised with the cytological lesions aggravation and CIN levels increasing（χ^2=11.111 ,χ^2=10.824,P〈0.05）; HPV positive rate was raised with cytological lesions aggravating（χ^2=6.570,P〈0.05）;hTERC gene amplification of HPV（＋） was higher than HPV （-）（χ^2=38.723 ,P〈0.05）. Conclusion： hTERC gene amplification is associated with cervical cytology and histology, hTERC gene amplification or not can differentiate low and high lesions, hTERC gene amplification may be an early stage event related to activation of telomerase resulted from HPV infection.