荧光原位杂交技术检测hTERC基因预测宫颈上皮内瘤样病变1级自然转归的前瞻性研究

Prospective study of human telomerase ribonucleic acid component gene detection by fluorescence in situ hybridization in predicting natural prognosis ofcervical intra-epithelial neoplasia 1

    摘要
  • 摘要:
      目的  探讨运用FISH方法检测hTERC基因, 预测子宫颈上皮内瘤变1级(CIN1)自然转归的可能性。
      方法  以人群为基础选取江西省2 499例30~49岁农村妇女, 对其进行了以病理为金标准的宫颈癌筛查。第一次病理学诊断有74例CIN1患者, 入组作为观察对象, 同时用宫颈细胞学样本进行hr-HPV HC-2和hTERC基因检测以了解基线情况。全部入组对象在知情同意的基础上进行为期2年的随访不行干预, 第12个月hr-HPV HC-2随访, 第24个月对所有对象进行hr-HPV HC-2+阴道镜检查并取活检, 以第24个月的随访病理结果评价hTERC基因和hr-HPV检测在预测宫颈上皮内瘤样病变1级自然转归中的作用。
      结果  74例CIN1患者全部随访24个月, 病变进展7例(9.5%), 病变持续为25例(33.8%), 病变消退42例(56.7%)。hTERC基因表达阳性组和阴性组间病变进展率(包括持续和进展)的差别有显著性差异(χ2=21.07, P < 0.001), hTERC基因表达阳性病变进展和持续的相对危险性是hTERC基因表达阴性组的3.24(1.96~5.37)倍。hr-HPV持续阳性组病变进展率和阴性组(hr-HPV转阴组+持续阴性组)的差异有统计学意义(χ2=7.645, P=0.006)。hTERC基因和初次检测hr-HPV两者均为阳性组病变进展率和两者均为阴性组的差异有统计学意义(χ2=4.544, P=0.033)。
      结论  hTERC基因异常扩增与宫颈上皮内瘤样病变1级进展和持续呈高度正相关。而hr-HPV需多次检测, 持续阳性与病变进展和持续相关, FISH方法检测hTERC基因异常扩增可能可单独预测CIN1自然转归。

     

    Abstract:
      Objective  his study aims to evaluate the prognostic significance of human telomerase ribonucleic acid component(hTERC) gene overexpression in the natural prognosis of cervical intraepithelial neoplasia grade 1(CIN1).
      Methods  A total of 2499 women aged 30 to 49 years were screened in a population-based cervical cancer screening study from the rural sites of Jiangxi Province.Using pathology as the gold standard, 74 CIN1 patients first diagnosed by pathological examination were studied.They were observed by carrying the hybrid capture2(hc2) and hTERC genetic testing to understand the baseline.All observed women accepted voluntary follow-up.In the first follow-up conducted 12 months after the screening, the subjects underwent high risk-human papillomavirus(hr-HPV) HC-2 testing.In the second follow-up carried out 24 months after the screening, the patients underwent hr-HPV HC-2, colposcopy, and pathological examinations.
      Results  A total of 74 CIN1 cases observed were followed-up for 24 months, with disease progression observed in 7 cases(9.5%), stable disease in 25(33.8%), and regression of disease in 42(56.7%).A significant difference in hTERC amplification was observed between the positive and negative groups(χ2=21.07, P < 0.001).The risk of CIN1 persistence and progression in the positive group was 3.24(1.96-5.37) times higher than that in the negative group.A significant difference was found between hr-HPV persist positive and turn to negative or persist negative group(χ2=7.645, P=0.006).A significant difference was also noted between the hTERC gene and the initial test of hr-HPV in both the positive and negative groups(χ2=4.544, P=0.033).
      Conclusion  A strong association was observed between the prevalence of hTERC gene overexpression and CIN1 natural prognosis.The follow-up results indicated that hr-HPV need repeated testing.A significant difference was noted between hr-HPV persist positive and turn to negative/ persist negative group(χ2=7.645, P=0.006).hTERC gene overexpression could prognoses CIN1 natural prognosis individually.

     

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