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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。
Objective To investigate the expression and clinical significance of telomerase (hTERC) gene in cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). Methods A total of 120 cases of cervical exfoliated cells from gynecological clinic of Zhuhai People’s Hospital from May 2008 to January 2009 were diagnosed by liquid-based cytology. Among them, 20 cases were normal cervical exfoliated cells and the remaining 100 The cases were classified into four groups according to the biopsy results: 53 cases of CINⅠ, 33 cases of CINⅡ, 12 cases of CINⅢ and 2 cases of SCC. Fluorescence in situ Hybridization (FISH) technique was used to detect the hTERC gene in exfoliated cells in the above groups. Results 20 cases of normal group used to determine the threshold, the laboratory threshold of 7%, the other groups positive judgments were compared with the threshold. The positive rates of hTERC expression in cervical exfoliated cells of CINⅠ, CINⅡ, CINⅢ and SCC were 18.9%, 87.8%, 91.7% and 100%, respectively. The positive rates of hTERC gene in CINⅡ, CINⅢ and SCC were significantly different from those in CINⅠ (P <0.01), while there was no significant difference in CINⅡ, CINⅢ and SCC between the two groups (P> 0.05). hTERC gene expression increased with the degree of cervical intraepithelial neoplasia and the direction of the development of the disease is closely related. Conclusions The expression of hTERC gene in CIN and SCC is abnormal. The expression of hTERC gene is increased with the degree of pathological change. The expression of hTERC gene in CINⅡ, CINⅢ and SCC is significantly higher than that of CINⅠ, which indicates that hTERC can be detected by using exfoliated cells Gene means effective identification of high-grade squamous intraepithelial neoplasia and monitoring the progress of cervical precancerous lesions.