论文部分内容阅读
目的:探讨应用FISH技术检测人端粒酶基因(human telomerase gene,hTERC)异常扩增在青海地区藏族妇女宫颈病变筛查中的临床意义。方法:选择400例门诊高危藏族妇女患者为研究对象,分别进行液基细胞学检查(LCT)、人乳头状瘤病毒(HC-Ⅱ HPV-DNA)检测,同时进行hTERC基因FISH检测。对上述结果有一项阳性者行阴道镜活组织病理检查。并与病理结果金标准相对比。结果:400例患者中LCT正常细胞学患者320例,非典型细胞(ASC)17例,低度病变(LSIL)43例,高度病变(HSIL)18例,宫颈癌2例。HC-Ⅱ HPV-DNA检测阳性者133例。hTERC基因异常扩增在正常组织学中12例,LSIL中13例,HSIL中19例,宫颈癌中2例,阳性率分别为3.61%、28.26%、95.00%、100.00%。其阳性率在正常组与LSIL和HSIL及宫颈癌组比较,hTERC基因异常扩增阳性率随着病变程度增加而增加,各组间差异有统计学意义(P<0.01)。结论:hTERC基因的异常扩增随病变加重而增加,其检出率也提高。在宫颈癌发生、发展中起重要作用,对预测早期病变进展有预测意义。联合应用LCT和HPV-DNA检测可显著提高宫颈癌的早期检出水平。
Objective: To investigate the clinical significance of detecting the abnormal amplification of human telomerase gene (hTERC) by FISH in screening Tibetan women with cervical lesions in Qinghai. Methods: A total of 400 outpatients with high risk Tibetan women were enrolled in this study. Liquid-based cytology (LCT) and human papillomavirus (HC-Ⅱ) were used to detect hTERC gene simultaneously. Colorectal biopsy was performed on one of the above positive results. And compared with the gold standard pathological results. Results: Among the 400 patients, there were 320 cases of LCT normal cytology, 17 cases of atypical cells (ASC), 43 cases of low grade lesions (LSIL), 18 cases of high grade lesions (HSIL) and 2 cases of cervical cancer. HC-Ⅱ HPV-DNA test positive in 133 cases. The abnormal amplification of hTERC gene was detected in 12 cases of normal histology, 13 cases of LSIL, 19 cases of HSIL and 2 cases of cervical cancer. The positive rates were 3.61%, 28.26%, 95.00% and 100.00% respectively. The positive rate of abnormal amplification of hTERC gene in normal group was significantly higher than that in LSIL, HSIL and cervical cancer group (P <0.01). Conclusion: The abnormal amplification of hTERC gene increases with the increase of the lesion, and the detection rate also increases. Plays an important role in the occurrence and development of cervical cancer and has a predictive value in predicting the progression of early stage lesions. The combination of LCT and HPV-DNA test can significantly improve the early detection of cervical cancer.