端粒酶基因在宫颈脱落细胞中的表达及其临床意义

Expression of human telomerase gene in cervical cytological specimens

关键词:  染色体畸变  宫颈肿瘤  端粒酶基因  ASCUS分流  荧光原位杂交（FISH）

Key words:  chromosome aberrations  uterine cervical neoplasm  telomerase gene  shunt of ASCUS  fluorescent in situ hybridization

摘要:

［目的］ 探讨人类染色体端粒酶（hTERC）基因在宫颈脱落细胞中的表达及其临床意义。［方法］ 收集2008年3月~2009年3月就诊于大连医科大学附属第一医院妇产科患者的宫颈脱落细胞标本，选取细胞学及组织学均正常的20例标本建立阈值，并选取100例细胞学异常或组织学异常标本，共120例宫颈脱落细胞标本参与实验，荧光原位杂交（FISH）方法检测脱落细胞hTERC基因。［结果］ CINⅡ/Ⅲ及宫颈癌组与正常组及CINⅠ组比较，hTERC基因阳性表达率均明显增高（P<0.05），且宫颈癌组表达率高于CINⅡ/Ⅲ组（P<0.05）。细胞学分级ASCUS及以上各组与正常组比较，hTERC基因阳性表达率均增高（P<0.05），且HSIL组及宫颈癌组表达率均较ASCUS组及LSIL组增高（P<0.05）。组织学分级中，CINⅡ、CINⅢ及宫颈癌的基因扩增异常细胞数目均高于正常组（P<0.05）。CINⅡ及以上级别病变基因扩增异常细胞数目约为（27±17）%，其单侧95%可信区间为μ>23.6%。hTERC基因对ASCUS样本的高级别病变阳性预测值为91%，阴性预测值为94%。［结论］ hTERC基因在CINⅡ/Ⅲ和宫颈癌中表达异常，且随病变程度增加阳性表达率增加。hTERC基因扩增异常细胞数≥24%可能成为检测CINⅡ及以上高级别病变的独立生物学指标并对ASCUS分流有一定的指导意义。

Abstract:

［Objective］ To evaluate the expression and significance of the human telomerase gene (hTERC) in cytological specimens of cervix.［Methods］ The threshold value was set up by 20 normal specimens.And 100 other specimens were taken in. The fluorescence signals of cervix cytologic samples were detected by using double-color DNA probes TERC.［Results］ The percentage of hTERC gene amplification in CINⅡ/Ⅲ and cervical cancer were significantly higher than that in normal (P<0.05). Distinctions were significant between CINⅠand CINⅡ/Ⅲ, CINⅠand cervical cancer, CINⅡ/Ⅲand cervical cancer. The percentage of hTERC gene amplification in ASCUS, LSIL, HSIL and cervical cancer were significantly higher than that in normal. Distinctions were significant between ASCUS and HSIL, ASCUS and cervical cancer, LSIL and HSIL, LSIL and cervical cancer (P<0.05). The abnormal amplifiable cell numbers of CINⅡand that of the uppers were significantly higher than that in normal (P<0.05). The abnormal cell number of CINⅡand the uppers was (27±17)%. The unilateral 95% confidence interval of the mean was that the μ>23.6%. The positive predictive value of hTERC gene for ASCUS samples was 91%, and the negative predictive value was 94%.［Conclusion］ The increase of hTERC expression is associated with the severity of cervical lesions. The abnormal cell number≥24% could be used as a biological parameter for CINⅡand the upper grades. And this maker may be helpful for the shunt of ASCUS.