Jiang Jing, Tu Zheng, Zhang Guo, Li Jing-Ran, Zhao Li-Jun, Zhao Chao, Cui Shu-Hui, Li Xiao-Ping, Chen Zhong, Wei Li-Hui
Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Nov;43(11):849-53.
To investigate the genomic amplification of the human telomerase RNA component (hTERC) gene in cervical cytology and evaluate its role in screening of cervical lesions.
A total of 301 cases were recruited, with liquid-based cytology diagnoses as normal (n = 203), atypical squamous cells (ASC, n = 66), low-grade squamous intraepithelial lesions (LSIL, n = 18), and high-grade squamous intraepithelial lesions (HSIL, n = 14). Following cytological examination, the slides were analyzed using a two-color fluorescence in situ hybridization (FISH) probe targeted to chromosome 3q26 containing hTERC. The hTERC findings were compared to the cytologic and histologic results, as well as high-risk human papilloma viruses (HPV) results.
Genomic amplification of hTERC was found in 3.0% (6/203) of normal specimens, 21.2% (14/66) of ASC, 44.4% (8/18) of LSIL and 92.9% (13/14) of HSIL, with a significant difference in each pair wise (all P < 0.05). Significantly more cells with 3q26 gain were found in cervical intraepithelial lesion (CIN)II than in CINI (75.0% vs. 20.0%), as well as in CINIII (86.7% vs. 20.0%) and squamous cervical cancer (SCC) than in CINI (100.0% vs. 20.0%)(all P < 0.01). The sensitivity of hTERC amplification was significantly higher than cytological screening (82.6% vs. 17.4%, P < 0.01), and its specificity was higher than high-risk HPV test (67.8% - 73.5% vs. 25.6% - 27.7%, P < 0.01) in the diagnosis of HSIL (CINII - III). The abnormal hTERC signal type mostly was 2:3 in CINI (84.9%); whereas in CINII - III, 2:3, 2:4 and 4:4 accounted for 44.6%, 24.8% and 17.8%, respectively.
Testing the gain of chromosome 3q26 in cytological specimens using specific probe for hTERC is powerful in screening of HSIL, and the amplification patterns of 2:4 and 4:4 may serve as potential prognosis markers.
研究人端粒酶RNA组分（hTERC）基因在宫颈细胞学中的基因组扩增情况，并评估其在宫颈病变筛查中的作用。
共纳入301例患者，液基细胞学诊断结果分别为正常（n = 203）、非典型鳞状细胞（ASC，n = 66）、低级别鳞状上皮内病变（LSIL，n = 18）和高级别鳞状上皮内病变（HSIL，n = 14）。细胞学检查后，使用针对包含hTERC的3q26染色体的双色荧光原位杂交（FISH）探针分析玻片。将hTERC检测结果与细胞学和组织学结果以及高危型人乳头瘤病毒（HPV）检测结果进行比较。
在正常标本中，hTERC基因组扩增的发生率为3.0%（6/203），ASC中为21.2%（14/66），LSIL中为44.4%（8/18），HSIL中为92.9%（13/14），两两比较差异均有统计学意义（均P < 0.05）。宫颈上皮内瘤变（CIN）II中3q26获得的细胞明显多于CINI（75.0%对20.0%），CINIII（86.7%对20.0%）和宫颈鳞癌（SCC）中3q26获得的细胞也明显多于CINI（100.0%对20.0%）（均P < 0.01）。在HSIL（CINII - III）诊断中，hTERC扩增的敏感性显著高于细胞学筛查（82.6%对17.4%，P < 0.01），其特异性高于高危型HPV检测（67.8% - 73.5%对25.6% - 27.7%，P < 0.01）。CINI中异常hTERC信号类型大多为2:3（84.9%）；而在CINII - III中，2:3、2:4和4:4分别占44.6%、24.8%和17.8%。
使用针对hTERC的特异性探针检测细胞学标本中3q26的获得情况对HSIL筛查有重要作用，2:4和4:4的扩增模式可能作为潜在的预后标志物。
