Department of Obstetrics & Gynecology, Jinan Military General Hospital, 25 Shifan Road, Jinan 250031, China.
World J Surg Oncol. 2012 Aug 21;10:168. doi: 10.1186/1477-7819-10-168.
Currently the routine non-invasive screening methods for cervical intraepithelial neoplasia (CIN) and cervical cancer are Thinprep cytology test (TCT) and human papillomavirus testing. However, both methods are limited by the high false positive and false negative rates and lack of association with patients' prognosis, especially for the early detection of pro-malignant CIN. The aim of the study was to investigate the role of genomic amplification of human telomerase gene (hTERC) in the diagnosis and prognosis of CIN.
The study group consisted of specimens of exfoliated cervical cells from 151 patients, including 27 with CIN I, 54 with CIN II/III, 17 with carcinoma in situ, and 28 with invasive squamous carcinoma, as well as 25 patients who were at 2-year follow-up after either Loop Electrosurgical Excision treatment (n = 11) or radical surgery (n = 14). hTERC amplification was detected by dual-color interphase fluorescence in situ hybridization (FISH), and the results were compared with TCT and histologic examination. The final diagnosis was determined by the pathological examination. The control group consisted of specimens of exfoliated cervical cells from 40 normal women.
The percentage of cervical exfoliated cells with positive hTERC amplification and incidence rates of hTERC amplification were 9.2% ± 4.6% and 44.4% (12/27) respectively in patients with CIN I; 16.0% ± 14.4% and 85.1% (46/54) in patients with CIN II/III; 19.7% ± 13.3% and 88.3% (15 /17) in patients with carcinoma in situ; 47.0% ± 25.2% and 100% (28/28)in patients with invasive squamous carcinoma. There was statistically significant difference between the control and study group (P <0.01), and between the patients with various diseases within the study group (P <0.05).
The detection of genomic amplification of hTERC using FISH is a non-invasive and effective approach for CIN.
目前，宫颈上皮内瘤变（CIN）和宫颈癌的常规非侵入性筛查方法是 Thinprep 细胞学检测（TCT）和人乳头瘤病毒检测。然而，这两种方法都受到高假阳性和假阴性率的限制，并且与患者的预后缺乏关联，特别是对于恶性前 CIN 的早期检测。本研究旨在探讨人类端粒酶基因（hTERC）基因组扩增在 CIN 诊断和预后中的作用。
研究组包括 151 例宫颈脱落细胞标本，其中 27 例为 CIN I，54 例为 CIN II/III，17 例为原位癌，28 例为浸润性鳞状细胞癌，25 例为 2 年后行 Loop 电切术（n = 11）或根治性手术（n = 14）的患者。通过双色间期荧光原位杂交（FISH）检测 hTERC 扩增，将结果与 TCT 和组织学检查进行比较。最终诊断由病理检查确定。对照组包括 40 例正常女性的宫颈脱落细胞标本。
CIN I 患者的宫颈脱落细胞 hTERC 扩增阳性率和阳性率分别为 9.2%±4.6%和 44.4%（12/27）；CIN II/III 患者分别为 16.0%±14.4%和 85.1%（46/54）；原位癌患者分别为 19.7%±13.3%和 88.3%（15/17）；浸润性鳞状细胞癌患者分别为 47.0%±25.2%和 100%（28/28）。与对照组相比，研究组差异有统计学意义（P<0.01），且研究组内不同疾病患者之间差异也有统计学意义（P<0.05）。
FISH 检测 hTERC 基因组扩增是一种非侵入性的、有效的 CIN 检测方法。
