Li Yi-bing, Wulan Na, Liu Zhi-hong, Li Juan, Wang Chun, Zhou Yan-qiu, Wu Rui-fang
Department of Obstetrics and Gynecology of Peking University Shenzhen Hospital, Shenzhen 518036, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Sep;30(9):946-50.
To study the amplification of human telomerase RNA component (hTERC) gene in the cervical exfoliated cells from natural population in Shenzhen and to explore its relationship with human pappiloma-virus (HPV) infection, abnormal cervical cytology and cervical intraepithelial neoplasia (CIN).
Three hundred and eighty-eight women, 30 - 59 year-old and having normal intelligence in a community of Shenzhen, were examined with liquid-based cytology. Human pappiloma-virus (HR-HPV) was tested by hybrid capture II (HC-II) and hTERC gene detection by fluorescence in situ hybridization (FISH). Patients with ASCUS and above lesion, and/or positive HR-HPV results and/or amplification of hTERC gene were examined by colposcopy, multiple biopsies of cervical quadrant and pathology.
The frequencies of CIN I, II, III, cervical cancer were 55 (14.18%), 4 (1.03%), 9 (2.32%) and 1 (0.26%) respectively, with the rate of hTERC gene amplification as 8.76%. There were significantly differences of hTERC amplification among the samples with different cytological and histological lesions as well with HPV infection (P < 0.01). (1) The positive rate of HPV infection was 17.01%; the positive rates of hTERC gene amplification were 19.70% in HPV positive and 6.52% in HPV negative samples and the results were significantly different (P < 0.01). (2) Cytologically, the rates of hTERC gene amplification appeared to be as follows: NILM (5.97%), ASCUS (18.75%), LSIL (10.00%), ASC-H (66.67%), HSIL (100.00%). There was a marked increase of hTERC amplification in patients with HSIL and above lesions (P < 0.01). (3) On histology findings, the rates of hTERC gene amplification were as follows: NILM (0%), CIN I (5.45%), CIN II (50.00%), CIN III (77.78%), and invasive carcinoma (100.00%). There was a marked increase of hTERC amplification in patients with CIN II and above lesions (P < 0.01).
There was a close correlation between amplification of hTERC and histological as well cytological lesions which increased progressively along with the severity of cytological and histological grade. The evidence of hTERC, with or without amplification, might serve as a prognostic indicator to measure the grade of lesion.
研究深圳自然人群宫颈脱落细胞中人端粒酶RNA组分（hTERC）基因的扩增情况，并探讨其与人类乳头瘤病毒（HPV）感染、宫颈细胞学异常及宫颈上皮内瘤变（CIN）的关系。
对深圳某社区388名年龄在30 - 59岁、智力正常的女性进行液基细胞学检查。采用杂交捕获二代法（HC-II）检测人类乳头瘤病毒（HR-HPV），荧光原位杂交法（FISH）检测hTERC基因。对非典型鳞状细胞不能明确意义（ASCUS）及以上病变、和/或HR-HPV检测结果阳性、和/或hTERC基因扩增的患者进行阴道镜检查、宫颈象限多点活检及病理检查。
CIN I、II、III及宫颈癌的发生率分别为55例（14.18%）、4例（1.03%）、9例（2.32%）和1例（0.26%），hTERC基因扩增率为8.76%。不同细胞学和组织学病变以及HPV感染的样本中hTERC扩增存在显著差异（P < 0.01）。（1）HPV感染阳性率为17.01%；HPV阳性样本中hTERC基因扩增阳性率为19.70%，HPV阴性样本中为6.52%，差异有统计学意义（P < 0.01）。（2）在细胞学上，hTERC基因扩增率依次为：未见上皮内病变或恶性病变（NILM，5.97%）、ASCUS（18.75%）、低度鳞状上皮内病变（LSIL，10.00%）、不典型鳞状细胞不排除高度鳞状上皮内病变（ASC-H，66.67%）、高度鳞状上皮内病变（HSIL，100.00%）。HSIL及以上病变患者的hTERC扩增明显增加（P < 0.01）。（3）在组织学检查中，hTERC基因扩增率依次为：NILM（0%）、CIN I（5.45%）、CIN II（50.00%）、CIN III（77.78%）和浸润癌（100.00%）。CIN II及以上病变患者的hTERC扩增明显增加（P < 0.01）。
hTERC扩增与组织学及细胞学病变密切相关，且随着细胞学和组织学分级的加重而逐渐增加。hTERC扩增与否的证据可作为评估病变程度的预后指标。
