目的探讨宫颈上皮内瘤变(CIN)和宫颈癌细胞涂片内人类染色体端粒酶基因(hTERC)扩增情况及其临床意义。方法2007年12月至2008年12月收集济南军区总医院107例宫颈脱落上皮标本,包括对照组20例;研究组87例,其中27例CIN(Ⅰ级8例、Ⅱ~Ⅲ级19例)和45例宫颈鳞癌(原位癌7例、Ⅰ期14例、≥Ⅱ期24例),术后2年受访15例(宫颈电热圈环切术治疗后12例,宫颈癌术后3例)。应用双色间期荧光原位杂交(FISH)技术,检测上述标本的hTERC基因扩增情况,并与液基薄层细胞检测(TCT)和病理学对照。结果(1)由对照组得出正常值为≤6.0%,>6.0%即为阳性。(2)27例CIN:Ⅰ期出现hTERC基因扩增阳性细胞百分数为9.17±4.62,阳性率为50.0%(4/8);CINⅡ~Ⅲ期为16.00±14.44,阳性率为84.2%(16/19);原位癌为19.67±13.26,阳性率为85.7%(6/7)。CIN组、原位癌组和浸润型癌组hTERC基因扩增阳性细胞百分数均显著高于对照组(P<0.01);CINⅠ期组和Ⅱ~Ⅲ组、原位癌组、Ⅰ期宫颈浸润型鳞癌组和≥Ⅱ期组之间hTERC基因扩增阳性细胞百分率递次增高,差异有统计学意义(P<0.05)。结论对于CIN,FISH检测宫颈上皮hTERC基因扩增是目前较新型的无创筛查方法,特别是对于辨别CIN是否具备恶性进展潜能具有重要意义。 Objective To investigate the clinical significance of human telomerase reverse transcriptase (hTERC) amplification in cervical intraepithelial neoplasia (CIN) and cervical cancer cell smears. Methods From December 2007 to December 2008, 107 cases of cervical exfoliated epithelial specimens from Jinan General Hospital of PLA were collected, including 20 cases of control group. 87 cases of study group including 27 cases of CIN (grade Ⅰ in 8 cases, grade Ⅱ ~ Ⅲ in 19 cases) And 45 cases of squamous cell carcinoma of the cervix (7 in situ carcinoma, 14 in stage Ⅰ, 24 in stage Ⅱ) and 15 in 2 years after operation (12 cases after cervical electric ring excision, 3 cases after cervical cancer example). The amplification of hTERC gene was detected by two-color fluorescence in situ hybridization (FISH), and was compared with TCT and pathology. Results (1) The control group was normal ≤6.0%,> 6.0% is positive. (2) In 27 cases of CIN, the percentage of positive hTERC gene amplification in stage Ⅰ was 9.17 ± 4.62, and the positive rate was 50.0% (4/8). The positive rate of CINⅡ ~ Ⅲ was 16.00 ± 14.44, the positive rate was 84.2% 19). The carcinoma in situ was 19.67 ± 13.26 with a positive rate of 85.7% (6/7). The percentage of hTERC gene positive cells in CIN group, in situ carcinoma group and invasive carcinoma group was significantly higher than that in control group (P <0.01). In CINⅠ group and Ⅱ ~ Ⅲ group, in situ carcinoma group, stage Ⅰ cervical invasive type The percentage of hTERC gene positive cells in squamous cell carcinoma group and ≥Ⅱphase group increased successively, the difference was statistically significant (P <0.05). Conclusion For CIN, FISH detection of cervical epithelial hTERC gene amplification is a relatively new noninvasive screening method, especially for identifying the potential of malignant progression of CIN is of great significance.