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目的:探讨人端粒酶RNA(hTERC)基因在宫颈腺癌中的扩增以及在宫颈腺癌诊断和预后评估中的价值。方法:收集南京医科大学附属南京妇幼保健院2006年1月～2009年12月诊断为宫颈腺癌的石蜡标本38例,并随机抽取同时期诊断为宫颈鳞状上皮内瘤变而腺体正常的37例标本作为对照,采用荧光原位杂交(FISH)方法检测hTERC基因在腺癌及对照组宫颈腺体中的扩增。结果:腺癌组hTERC基因扩增阳性率为84.21%(32/38),对照组阳性率为0%(0/37),两组差异有显著统计学意义(P<0.01)。hTERC基因扩增检测的灵敏度为84.21%(32/38),特异度为100%(37/37),阳性预测值为100%(32/32),阴性预测值为86.05%(37/43)。FISH检测结果显示,不同亚型的宫颈腺癌阳性检出率各不相同,高分化和中-低分化的宮颈腺癌hTERC基因扩增程度存在差异(P<0.05)。对照组杂交信号多为2∶2,而腺癌组异常扩增类型有2∶3、2∶4、2∶5、3∶3、4∶4及N∶N。不同hTERC基因扩增程度的腺癌预后结果差异无统计学意义(P>0.05)。结论:hTERC基因在宫颈腺癌中扩增,病理分化程度不同hTERC基因扩增有差异,可作为宫颈腺癌的病理诊断辅助指标,尚未发现hTERC基因扩增程度与宫颈腺癌的不良预后有相关性。
Objective: To investigate the amplification of human telomerase RNA (hTERC) gene in cervical adenocarcinoma and its value in diagnosis and prognosis of cervical adenocarcinoma. Methods: 38 cases of cervical adenocarcinoma diagnosed in Nanjing Maternal and Child Health Hospital Affiliated to Nanjing Medical University from January 2006 to December 2009 were collected and randomly selected for cervical squamous intraepithelial neoplasia 37 specimens were used as controls, and fluorescent in situ hybridization (FISH) was used to detect the amplification of hTERC gene in cervical adenocarcinoma and control group. Results: The positive rate of hTERC gene amplification was 84.21% (32/38) in adenocarcinoma group and 0% (0/37) in control group. The difference was statistically significant (P <0.01). The sensitivity of hTERC gene amplification assay was 84.21% (32/38), specificity was 100% (37/37), positive predictive value was 100% (32/32), negative predictive value was 86.05% (37/43) . FISH test results showed that different subtypes of cervical adenocarcinoma positive rate of different, high differentiated and moderate - poorly differentiated cervical adenocarcinoma hTERC gene amplification difference (P <0.05). In the control group, the hybridization signal was mostly 2: 2, while in the adenocarcinoma group, the types of abnormal amplification were 2: 3, 2: 4, 2: 5, 3: 3, 4: 4 and N: N. There was no significant difference in the prognosis of adenocarcinoma between different hTERC gene amplification (P> 0.05). CONCLUSION: hTERC gene is amplified in cervical adenocarcinoma and has different pathological differentiation of hTERC gene amplification, which can be used as an auxiliary indicator of pathological diagnosis of cervical adenocarcinoma. However, it has not been found that the degree of hTERC gene amplification correlates with the poor prognosis of cervical adenocarcinoma Sex.