荧光原位杂交检测端粒酶基因在宫颈癌前病变中的表达及意义

目的探讨端粒酶（hTERC）基因在子宫颈上皮内瘤变（CIN）及鳞状细胞癌（SCC）中的表达及临床意义。方法收集2008年5月至2009年1月珠海市人民医院妇科门诊就诊的120例患者的子宫颈脱落细胞标本,经液基细胞学制片诊断,其中20例为正常子宫颈脱落细胞,其余100例均为不能明确意义的非典型细胞（ASC-US）,后者根据病理活检结果分为四组：CINⅠ级53例,CINⅡ级33例,CINⅢ级12例以及SCC 2例,采用荧光原位杂交（FISH）技术检测上述各组脱落细胞中的hTERC基因。结果正常组20例用于确定阈值,本实验室阈值为7%,其他各组阳性判断均通过与阈值比较得来。在CINⅠ级、CINⅡ级、CINⅢ级和SCC患者宫颈脱落细胞中,hTERC基因的表达阳性率分别是18.9%、87.8%、91.7%和100%。CINⅡ级、CINⅢ级及SCC组与CINⅠ级比较,hTERC基因表达阳性率比较差异有统计学意义（P〈0.01）,CINⅡ级、CINⅢ级及SCC两两比较,差异均无统计学意义（P〉0.05）。hTERC基因表达增加与子宫颈上皮内瘤变的程度及病变发展的方向关系十分密切。结论 hTERC基因在CIN和SCC中表达异常,且随病变程度的增加其表达阳性率增加,在CINⅡ级、CINⅢ级及SCC中的扩增明显高于CINⅠ级,提示我们可以通过利用脱落细胞检测hTERC基因的手段有效识别高级别鳞状上皮内瘤变及监测宫颈癌前病变的进展。

Expression and significance of the human telomerase gene by FISH in cervical precancerous lesions

Objective To explore the expression and clinical significance of the human telomerase gene（hTERC） in cervical intraepithelial neoplasia and squamous carcinomas.Methods The fluorescence signal of cytologic samples of cervix from 20 normal cervix,53 cervical intraepithelial neoplasiaⅠ（CIN Ⅰ）,33 cervical intraepithelial neoplasia Ⅱ（CIN Ⅱ）,12 cervical intraepithelial neoplasia Ⅲ（CIN Ⅲ）and 2 cervical squamous carcinomas were detected by dual-color interphase fluorescence in situ hybridization（FISH） in chromosome enumeration double-color DNA probes TERC.Results Positive expression rate of the hTERC gene in CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC were 18.9%,87.8%,91.7% and 100%.Compared with CIN Ⅰ,hTERC gene positive expression rate of CIN Ⅱ,CIN Ⅲ,SCC were different significantly（P〈0.01）,and there was no significantly difference between CIN Ⅱ,CIN Ⅲ and SCC（P〉0.05）.Conclusion Our study indicated that over-expression of hTERC gene may play an important role in cervical carcinogenesis,therefore it can be used as a better tumor index for early cervical cancer screening and served as a screening testmarker for CIN Ⅱ/Ⅲ which may help to determine the progressive potential of individual lesions.