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宫颈病变中hTERT基因扩增与高危型HPV感染的关系

李洪林1,尹利荣2,孙俊杰2   

  1. 1. 天津医科大学第二医院
    2. 医大二院
  • 收稿日期:2013-08-12 修回日期:2013-10-22 出版日期:2014-02-15 发布日期:2014-02-15
  • 通讯作者: 李洪林

The relationship between hTERT gene amplification with High-risk HPV infection in cervical lesions

  • Received:2013-08-12 Revised:2013-10-22 Published:2014-02-15 Online:2014-02-15
  • Contact: linda li

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摘要： 【摘要】 目的 探讨人端粒酶逆转录酶（hTERT）基因扩增和高危型人乳头瘤病毒（HR-HPV）感染在宫颈病变中关系。方法 连续入选2012年9月—2013年4月天津医科大学第二医院妇科就诊患者的宫颈脱落细胞标本，应用荧光原位杂交技术（FISH）检测34例正常人，31例宫颈上皮内瘤变(CIN) I 级，33例CIN II 级，34例CIN III 级，20例宫颈癌患者的hTERT基因扩增情况并对上述研究对象进行HPV DNA检测。结果 5组样本中随宫颈病变级别的升高,HR-HPV DNA的阳性率分别为20.59%、54.84%、72.73%、85.29%、90.00%，差异具有统计学意义（?2=41.448，P<0.05），正常组分别与CIN II级、CIN III级、宫颈癌组比较，各组间差异有统计学意义(P<0.005)。5组样本中随着宫颈病变的加重，hTERT基因扩增的阳性率分别为0.00%、3.22%、18.18%、41.18%、80.00%，差异具有统计学意义（?2=57.998，P<0.05），宫颈癌组分别与正常组、CINⅠ级、CIN II级比较，各组间差异有统计学意义(P<0.005)。总样本中所有HR-HPV阳性患者中hTERT基因扩增阳性率为33.68%；而HR-HPV阴性患者中，hTERT基因扩增阳性率为8.77%，两者比较差异有统计学意义(P<0.05) 。hTERT基因扩增与HR-HPV感染呈正相关( P<0.05，r= 0.2381)。结论 (1)HR-HPV阳性率随着宫颈病变级别升高而增高。(2)hTERT基因扩增阳性率随着宫颈病变级别的加重而增高，故hTERT基因检测可能作为宫颈癌前病变监测的辅助指标，应用于临床早期宫颈病变的诊断中。(3)宫颈病变中hTERT基因扩增与高危型HR-HPV感染呈正相关，提示HR-HPV的感染可能是hTERT基因异常扩增的早期事件。

关键词: 人端粒酶逆转录酶, 宫颈癌, 宫颈上皮内瘤变, 高危型人乳头瘤病毒, 荧光原位杂交技术

Abstract: 【Abstract】 Objective: To investigate the relationship between the amplification of human telomerase reverse transcriptase (hTERT) gene and High-risk human papillomavirus(HR-HPV) infections in cervical intraepithelial neoplasia（CIN）and cervix carcinoma. Methods: The cytological specimens of cervix were selected from Sep 2012 to Apr 2013 in department of gynaecology second hospital of tianjin medical university。The amplification of hTERT gene of cervical epithelial cells in human normal cervical epithelium of 34 cases, CIN I of 31 cases, CIN II of 33 cases, CIN III of 34 cases and cervical carcinoma of 20 cases were detected by fluorescence in situ hybridization( FISH).All of them received HPV DNA detection. Results: With aggravated cervical lesions, the incidence of HR-HPV infection were 20.59%、54.84%、72.73%、85.29%、90.00%，respectively and there was significant difference between them (?2=41.448,P<0.05).The incidence of HR-HPV infection between normal cervical epithelium and the CIN II or the CIN III or the cervix carcinoma was significant difference(P<0.005)，while there was no significant difference between the normal group and the CIN I(P>0.005). With the increase in grades of cervical lesions, the positive rate of hTERT gene were 0.00%、3.22%、18.18%、41.18%、80.00%，respectively and there was significant difference between them (?2=57.998，P<0.05).The positive rate of hTERT gene between the cervix carcinoma and normal group or the CIN I or the CIN II was significant difference(P<0.005), however there was no significant difference between the cervix carcinoma and the CIN III(P>0.005).The positive rate of hTERT gene was 33.68% with HR-HPV infection, however 8.77% without HR-HPV infection, there was significant difference between them (P<0.05).There was positive correlation between the amplification of hTERT gene and HR-HPV infection (P<0.05，r= 0.2381).Conclusion: (1)the incidence of HR-HPV infection increase as significantly as aggravating the lesions.(2)The positive rate of hTERT gene increased with the cervical lesion grade which makes it a screening test marker for CIN and may help to determine the progressive potential of individual lesions.(3)The amplification of hTERT gene may be an early stage event which related to the activation of telomerase resulted from HR-HPV infection．The detection of HPV-DNA and hTERT gene can be used as ideal tumor indexes for early cervical lesions screening． Key words Fluorescence in situ hybridization；Cervix carcinom；，Cervical intraepithelial neoplasia；High-risk human papillomavirus,；Human telomerase reverse transcriptase

Key words: Human telomerase reverse transcriptase, Cervix carcinom, Cervical intraepithelial neoplasia, High-risk human papillomavirus, Fluorescence in situ hybridization