子宫颈上皮内瘤变端粒酶活性的研究

目的探讨端粒酶激活在宫颈癌变过程中的意义及其作为病情监测方法和预测宫颈上皮内瘤变(CIN)结局的可能性.方法采用端粒重复序列扩增-聚合酶链反应(PCR-TRAP)方法检测了64例CIN患者、21例宫颈癌患者、20例慢性宫颈炎患者及15例正常宫颈妇女宫颈脱落细胞、宫颈活组织检查(活检)组织的端粒酶活性.结果正常宫颈、慢性宫颈炎、CINⅠ级(CINⅠ)、CINⅡ级(CINⅡ)、CINⅢ级(CINⅢ)及宫颈癌患者的宫颈脱落细胞端粒酶的阳性表达率分别为20.0%、25.0%、62.5%、60.0%、82.4%及61.9%;对应的活检组织端粒酶的阳性表达率分别为26.7%、30.0%、50.0%、45.0%、96.4%及95.2%;随着宫颈病变的进展,端粒酶阳性表达率呈逐渐增高趋势(X2细胞=16.28、X2组织=36.98,P均＜0.05).CINⅠ、CINⅡ端粒酶阳性表达率比较,差异无显著性(P细胞=0.24、P组织=0.25);CINⅢ端粒酶阳性表达率高于CINⅠ、CINⅡ(P细胞=0.03、P组织=0.000012);CINⅢ与宫颈癌活检组织端粒酶阳性表达率比较,差异无显著性(P=0.05);宫颈脱落细胞与宫颈活检组织的端粒酶检测结果的对应性良好(X2=46.4,P＜0.05).结论端粒酶激活与宫颈癌变的进程有关,宫颈脱落细胞端粒酶活性检测可以作为CIN病情检测、处理及预后估计的辅助指标.

Telomerase activity in cervical intraepithelial neoplasia

OBJECTIVE: To investigate the relationship between telomerase expression and the carcinogenesis of cervix, and the possibility of using telomerase as a marker to evaluate the natural history of cervical intraepithelial neoplasia (CIN). METHODS: Use the telomere repeat amplification protocol (TRAP) assay to detect cervical lesion in cervical scraping samples and cervical biopsy tissues. RESULTS: Sixty two point five percent, 60.0 percent, 82.4 percent and 61.9 percent cervical scraping samples exhibited telomerase activity in CINI, CINII, CINIII and cervical cancer, respectively, compared 50.0 percent, 45.0 percent, 96.4 percent and 95.2 percent in cervical biopsy tissue. In contrast, 20.0 percent and 26.7 percent in cervical scraping samples and cervical biopsy tissues of normal cervix. With the development of cervical lesion, the expression of tolemerase activation was increasing (P < 0.05). There was no significant difference between CINI and CINII (P > 0.05). There were significant differences between CINIII and CINI, CINII (P < 0.05) Telomerase activity was coincidence between the cervical scraping samples and cervical biopsy tissues. CONCLUSIONS: These results seem to suggest that the Telomerase expression may associate with the carcinogenesis of cervix. The telomerase activity assay of cervical scraping sample could be used as a marker to monitor and predicate the transit of CIN in clinical practice.