FISH技术检测宫颈病变石蜡标本hTERC基因扩增情况的临床意义
2017-11-6 10:28:02 http://www.biog.org.cn 来源：北京妇产学会
罗新1，伍军平1，甘丹卉2，陈舒1
暨南大学附属第一医院妇产科1，病理科2 广东 广州 510630
摘要 目的 探讨宫颈上皮内瘤变（CIN）及宫颈癌石蜡标本中人染色体端粒酶基因（hTERC）表达情况及其临床意义。方法 收集2008年10月至2010年3月暨南大学附属第一医院102例宫颈活检或切除宫颈石蜡标本，其中对照组10例（正常宫颈），研究组92例（CINⅠ级20例，CINⅠ-Ⅱ级28例，CINⅡ级20例，CINⅢ级14例，宫颈癌10例）。应用荧光原位杂交（FISH）技术检测上述标本的hTERC基因表达情况。CINⅠ-Ⅱ级以上病变予以相应治疗，术后6-12月复查HPV，并与术前进行比较。结果 （1）对照组中hTERC基因阳性表达率为0.0%（0/10），研究组中CINⅠ、Ⅰ-Ⅱ、Ⅱ、Ⅲ级及宫颈癌hTERC基因阳性表达率分别为5.0%（1/20）、32.1%（9/28）、70.0%（14/20）、92.9%（13/14）及90.0%(9/10)。随着宫颈病变级别增高，hTERC基因阳性表达率增加（p＜0.05）。（2）术后随访72例，45例hTERC基因扩增病例中13例出现高危型HPV阳性，占28.9%（13/45，CINⅠ-Ⅱ1/9，CINⅡ6/14，CINⅢ4/13，宫颈癌2/9），其中同一亚型占46.2%（6/13），其它亚型占53.8%（7/13）。27例hTERC基因无扩增中2例出现高危型HPV阳性，占7.4%（2/27）。两组比较具有统计学意义（p＜0.05）。结论 FISH技术检测宫颈石蜡标本中hTERC基因具有更高的敏感性和特异性，对CINⅠ-Ⅱ级分流处理及指导CIN术后随诊具有较好的临床意义。
关键词：荧光原位杂交，石蜡切片，宫颈上皮内瘤变，人染色体端粒酶基因
Detection of genomic amplification of hTERC gene in cervical paraffin tissues by FISH and its clinical significance
Luo Xin Wu Junping Gan Danhui Chen Shu
The First Affiliated Hospital of Jinan University, Guangzhou 510630, China
Abstract: Objective To investigate the genomic amplification of human telomerase gene (hTERC) in paraffin tissues of cervical intraepithelial neoplasia (CIN) and cervical carcinoma in order to evaluate its clinical significance.Method The genomic amplification of hTERC gene in 102 cases of cervical paraffin-embedded tissues were delected by the fluorescence in situ hybridization (FISH) in the First Affiliated Hospital of Jinan University from October 2008 to March 2010. According to histology biopsy, 102 cases divided into the control group (n= 10 normal cases) as negative control ,10 cases as positive control)and the study group(n=92: 20 CINⅠ, 28 CINⅠ-Ⅱ, 20 CINⅡ,14 CINⅢand 10 cervical cancer).The cases with ≥CINⅠ-Ⅱstage were redetected HPV-DNA at 6-12 months after treatment with surgery. Result （1）The genomic amplification rate of hTERC in normal cervix was 0.0%（0/10）. While in CINⅠ、Ⅰ-Ⅱ、Ⅱ、Ⅲ and cervical cancer were5.0%（1/20）、32.1%（9/28）、70.0%（14/20）、92.9%（13/14）and 90.0%(9/10)respectively. The percentage of genomic amplification increased with the severity of the cervical lesions（p＜0.05）.（2）In the study group, there were 13 cases showed high -risk HPV(HR-HPV)positive in 45 ones with hTERC gene amplification of 72 following-up patients, accounting for 28.9% (13/45，CINⅠ-Ⅱ1/9, CINⅡ6/14, CINⅢ grade 4/13 and cervical cancer2/9 )，which accounted for 46.2% of the same subtype (6 / 13), other subtypes accounted for 53.8% (7/13). 2 patients in 27cases that hTERC gene without amplification showed HR-HPV positive, accounting for7.4%.There were statistically significant difference between positive and negetive hTERC gene（p＜0.05）.Conclusion The investigation of the hTERC genomic amplification in cervical important clinical significance in dealing with CIN Ⅰ - Ⅱ grade segregation and guiding the follow-up after CIN operation.
Key words:fluorescence in situ hybridization，paraffin-embedded，cervical intraepithelial neoplasia，human telomerase gene
