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目的:研究不同程度子宫颈病变中HPV负荷量和端粒酶(human telomerase gene,hTERC)基因的扩增情况,以探讨两者在宫颈癌发生发展中的作用及相关性。方法:采用第二代杂交捕获(HCⅡ)技术检测宫颈脱落细胞HPV-DNA含量并用荧光原位杂交(fluorescent in situ hybridization,FISH)方法对HCⅡ检测剩余宫颈细胞保存液进行hTERC检测。结果:①随着宫颈病变严重程度的增加,高危型HPV的病毒负荷量也增高,慢性宫颈炎组与CINⅠ组、CINⅡ、CINⅢ和宫颈癌组比较,差异有统计学意义(P<0.05);CINⅠ组与CINⅡ、CINⅢ和宫颈癌组比较差异有统计学意义(P<0.05);CINⅡ组、CINⅢ组和宫颈癌组之间比较差异无统计学意义(P>0.05)。②随着宫颈病变程度的加深,hTERC基因扩增阳性率逐渐升高。hTERC基因扩增阳性率除慢性宫颈炎组、其他各组与正常组对比均有统计学意义差异(P<0.05);慢性宫颈炎组与CINⅠ组比较无统计学意义差异(P>0.05),与CINⅡ、CINⅢ和宫颈癌组比较有统计学意义差异(P<0.05);CINⅠ组、CINⅡ组、CINⅢ组与宫颈癌组比较差异有统计学意义(P<0.05)。③随着HPV-DNA负荷量的增加,hTERC基因扩增阳性率也逐渐升高(r=0.995,P<0.01)。结论:HPV-DNA负荷量的增加与hTERC基因扩增在宫颈癌前病变及宫颈癌的发生发展中可能起了重要的作用,可作为子宫颈癌前病变和宫颈癌筛查的监测指标。
Objective: To study the HPV load and the amplification of telomerase gene (hTERC) gene in different degree of cervical lesions in order to explore the role and correlation between the two in the development of cervical cancer. Methods: Human cervical exfoliated cells were tested for HPV-DNA content by second generation hybridization capture (HCⅡ) technique and hTERC was detected by fluorescence in situ hybridization (FISH). Results: ①With the increase of the severity of cervical lesions, the viral load of high - risk HPV was also increased. There was significant difference between chronic cervicitis group and CIN Ⅰ group, CIN Ⅱ, CIN Ⅲ and cervical cancer group (P <0.05). There was significant difference between CINⅠgroup and CINⅡ, CINⅢand cervical cancer group (P <0.05). There was no significant difference between CINⅡgroup, CINⅢgroup and cervical cancer group (P> 0.05). With the deepening of cervical lesions, hTERC gene amplification positive rate increased gradually. The positive rate of hTERC gene amplification in chronic cervicitis group, the other groups compared with the normal group were statistically significant differences (P <0.05); chronic cervicitis group and CIN Ⅰ group was no significant difference (P> 0.05) Compared with CINⅡ, CINⅢand cervical cancer group, there was statistically significant difference (P <0.05). There was significant difference between CINⅠgroup, CINⅡgroup and CINⅢgroup and cervical cancer group (P <0.05). ③ With the increase of HPV-DNA load, the positive rate of hTERC gene amplification also gradually increased (r = 0.995, P <0.01). Conclusion: The increase of HPV-DNA load and hTERC gene amplification may play an important role in the development of cervical precancerous lesions and cervical cancer, which can be used as the monitoring indicators of cervical precancerous lesions and cervical cancer screening.