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目的:检测宫颈脱落细胞中端粒酶基因扩增的检出率,探讨其在宫颈病变中诊断的价值。方法:收集2007-07-27-2009-01-09哈尔滨医科大学附属第三临床医学院妇科113例宫颈脱落细胞标本,其中非典型鳞状上皮细胞(ASC)患者27例、低度鳞状上皮内病变(LSIL)患者33例、高度鳞状上皮内病变(HSIL)患者26例、宫颈鳞癌(SCC)患者2例以及正常细胞学妇女25位,用荧光原位杂交技术(FISH)检测脱落细胞人类染色体末端酶基因(hTERC)扩增情况,ASC以上各组进行病理组织学检查。结果:在ASC组、LSIL组、HSIL组、SCC组和正常组宫颈脱落细胞中,hTERC基因扩增检出率分别为44.4%(12/27)5、7.6%(19/33)、92.3%(24/26)、100.0%(2/2)和0,ASC组、LSIL组、HSIL组、SCC组与正常组比较,差异有统计学意义,P<0.001。在子宫颈上皮内瘤样病变(CIN)Ⅰ、CINⅡ/Ⅲ和SCC患者中,hTERC基因扩增检出率分别为60.0%(18/30)、73.9%(34/46)和100.0%(5/5),CINⅠ组、CINⅡ/Ⅲ组、SCC组与正常组比较,差异有统计学意义,P=0.001。结论:hTERC基因在CIN和SCC中表达异常,其拷贝数随病理学及细胞学分级增加而增加,可作为宫颈癌筛查的有效指标和癌前病变进展的生物遗传学监测指标。
Objective: To detect the detection rate of telomerase gene amplification in cervical exfoliated cells and to explore its value in the diagnosis of cervical lesions. METHODS: A total of 113 specimens of cervical exfoliated cells were collected from the Third Affiliated Hospital of Harbin Medical University during 2007-07-27-2009-01-09. Among them, 27 cases of atypical squamous cell carcinoma (ASC), 27 cases of low grade squamous epithelium 33 patients with LSIL, 26 patients with high grade squamous intraepithelial lesion (HSIL), 2 cervical squamous cell carcinoma (SCC) and 25 normal women were detected by fluorescence in situ hybridization (FISH) Cell end-human chromosome enzyme gene (hTERC) amplification, ASC above each group histopathological examination. Results: The detection rates of hTERC gene amplification in ASC group, LSIL group, HSIL group, SCC group and normal cervical exfoliated cells were 44.4% (12/27) 5, 7.6% (19/33), 92.3% (24/26), 100.0% (2/2) and 0 respectively. There was significant difference between ASC group, LSIL group, HSIL group and SCC group and normal group (P <0.001). In CIN Ⅰ, CINⅡ / Ⅲ and SCC, the detection rates of hTERC gene amplification were 60.0% (18/30), 73.9% (34/46) and 100.0% (5) respectively / 5), CINⅠgroup, CINⅡ / Ⅲgroup, SCC group compared with the normal group, the difference was statistically significant, P = 0.001. CONCLUSION: The expression of hTERC gene in CIN and SCC is abnormal. The copy number of hTERC gene increases with the increase of pathology and cytology grade. It can be used as a effective indicator of cervical cancer screening and a biogenetic monitoring indicator of the progression of precancerous lesions.