目的 应用荧光原位杂交技术(FISH)探讨宫颈病变中人类染色体端粒酶(hTERC)基因的异常扩增情况及其与人乳头瘤病毒(HPV)感染在宫颈病变中的关系.方法 对115例宫颈疾病患者,以病理检查为"金标准",根据宫颈活检病理诊断结果将其分为4组:对照组(包括宫颈组织正常及宫颈炎症)、宫颈上皮内瘤样变(CIN)Ⅰ组、CINⅡ~Ⅲ组和宫颈浸润癌组,对患者宫颈分泌物分别进行HPV杂交捕获Ⅱ代(HPV-HC2)检测、FISH检测.结果 (1)hTERC基因在对照组、CINⅠ组、CINⅡ~Ⅲ组和宫颈浸润癌中组的扩增率分别为21.1%、86.7%、93.8%和100.0%.宫颈浸润癌组、CINⅠ组和CINⅡ~Ⅲ组hTERC基因扩增率与对照组比较,差异均有统计学意义(P＜0.05).(2)83例HPV阳性患者中,hTERC基因扩增率为91.6% (76/83),32例HPV阴性患者中,hTERC基因扩增率为43.7% (14/32),差异有统计学意义(P＜0.05).(3)hTERC基因扩增与HPV阳性率的相关系数为0.520,两种检测方法有很好的一致性,hTERC基因检测总体评价高于HPV-HC2的检测.结论 hTERC基因的扩增与宫颈病变程度及HPV感染呈正相关,其扩增提示CIN有恶性进展潜能,其扩增情况可作为CIN病情进展的预测指标.%Objective To explore the abnormal amplification of hTERC gene in cervical diseases by florescence in situ hybridization ( FISH ) and the relationship between hTERC gene and HPV infection. Methods A total of 115 patients with cervical diseases were divided into four groups ( normal group, CIN I group, CIN II - HE group and cervical cancer group ) according to results from pathological examinations. FISH and HPV - HC2 tests were carried out on cervical excretions. Results Positive amplification rate of hTERC was 21. 1% in the normal group, 86. 7% in the CIN I group, 93. 8% in the CIN II - HI group and 100. 0% in the cervical cancer group, with statistically significant differences between the normal group and either of the other three groups ( P <0. 05 ). Amplification rate of hTERC gene was 91. 6% ( 76/83 ) in the 83 cases with HPV infection and was 43. 7% ( 14/32 ) in the 32 cases without HPV infection with significant differences ( P <0. 05 ). The correlation coefficient between abnormality of hTERC gene and HPV infection was 0. 520 with FISH better than HPV - HC2. Conclusion Amplification of hTERC gene, degrees of cervical lesions and HPV infection are positively correlated. High expression levels of hTERC gene indicate the development of the disease. The abnormality of hTERC gene in cervical diseases detected by FISH could serve as predictor for cervical cancer.
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