荧光原位杂交技术对宫颈癌和乳腺癌早期筛查的诊断价值及临床表达意义

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目的探讨荧光原位杂交(FISH)技术对宫颈癌和乳腺癌早期筛查的诊断价值及临床表达意义。方法选取本院2014年1月-2016年1月收集的宫颈标本117例,依据病理学检查结果将其分为正常(含宫颈炎)组27例,宫颈上皮内瘤变(CIN)Ⅰ级组29例,CINⅡ级组24例,CINⅢ级组19例,宫颈癌组21例;另外选取同期收集的乳腺癌标本82例。应用FISH技术检测宫颈标本中人类染色体端粒酶(h TERC)基因扩增情况;应用FISH技术与免疫组化技术分别检测乳腺癌标本中人类表皮生长因子受体2(HER-2)基因扩增情况。分析比较宫颈癌与正常患者中h TERC基因扩增阳性率及不同级别CIN患者中h TERC基因扩增阳性率;统计FISH技术检测HER-2基因扩增的灵敏度、特异度。结果宫颈癌组h TERC基因扩增阳性率[95.24%(20/21)]显著高于正常组[3.70%(1/27)],差异有统计学意义(P<0.05);CINⅡ级组h TERC基因扩增阳性率[50.00%(12/24)]高于CINⅠ级组的[20.69%(6/29)],CINⅢ级组h TERC基因扩增阳性率为[84.21%(16/19)]高于CINⅡ级组、CINⅠ级组[50.00%(12/24)、20.69%(6/29)],差异均具有统计学意义(均P<0.05);FISH技术检测HER-2基因扩增的灵敏度、特异度、误诊率分别为83.56%(61/73)、77.78%(7/9)、22.22%(2/9),漏诊率、阳性预测值、阴性预测值分别为16.44%(12/73)、96.83%(61/63)、36.84%(7/19)。结论 FISH技术在宫颈癌和乳腺癌早期筛查中诊断价值较高。 Objective To investigate the diagnostic value and clinical significance of fluorescence in situ hybridization (FISH) for early screening of cervical cancer and breast cancer. Methods A total of 117 cervical samples collected from January 2014 to January 2016 in our hospital were selected and divided into 27 cases of normal (including cervicitis) group and 1 case of cervical intraepithelial neoplasia (CIN) according to the results of pathological examination 29 cases, 24 cases of CIN Ⅱ level group, 19 cases of CIN Ⅲ level group and 21 cases of cervical cancer group. In addition, 82 cases of breast cancer samples collected in the same period were selected. FISH was used to detect the amplification of human chromosome telomerase (hTERC) gene in cervical specimens. The amplification of human epidermal growth factor receptor 2 (HER-2) gene in breast cancer specimens was detected by FISH and immunohistochemistry Happening. The positive rate of h TERC gene amplification in cervical cancer and normal patients and the positive rate of h TERC gene amplification in patients with different grades of CIN were analyzed. The sensitivity and specificity of HER-2 gene amplification were detected by statistical FISH. Results The positive rate of hTERC gene amplification in cervical cancer group was significantly higher than that in normal group [95.24% (20/21), 3.70% (1/27), P <0.05) The positive rate of TERC gene amplification [50.00% (12/24)] was higher than [20.69% (6/29)] in CINⅠgroup. The positive rate of TERC gene amplification in CINⅢgroup was 84.21% (16/19) ] Were significantly higher than those in CINⅡgroup (50.00% (12/24), 20.69% (6/29)) in CINⅠgroup (all P <0.05). The amplification of HER-2 gene was detected by FISH The sensitivity, specificity and misdiagnosis rates were 83.56% (61/73), 77.78% (7/9) and 22.22% (2/9), respectively. The misdiagnosis rate, positive predictive value and negative predictive value were 16.44% (12 /73),96.83%(61/63),36.84%(7/19). Conclusion FISH has high diagnostic value in early screening of cervical cancer and breast cancer.
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