發(fā)布時(shí)間：2018-05-11 19:36

  本文選題：宮頸病變 + 人乳頭瘤病毒��； 參考：《河北北方學(xué)院》2014年碩士論文

【摘要】：宮頸癌是危害女性健康的第二大惡性腫瘤，近年來(lái)宮頸癌的發(fā)病率及病死率得到顯著改善，得益于宮頸癌篩查工作的開(kāi)展，由此可見(jiàn)宮頸癌的篩查方法顯得尤為重要。持續(xù)性HR-HPV感染是導(dǎo)致宮頸癌發(fā)生的主要致病原因，這一觀點(diǎn)已得到普遍公認(rèn)。在大約70%的宮頸癌中，其染色體異常主要表現(xiàn)為3號(hào)染色體長(zhǎng)臂的異常擴(kuò)增，人類染色體端粒酶基因（hTERC）位于此區(qū)域。本研究探討hTERC基因在不同亞型HPV感染宮頸組織中的表達(dá)及其臨床意義。 通過(guò)對(duì)2012年8月至10月河北省赤城縣參加河北北方學(xué)院附屬第一醫(yī)院婦產(chǎn)科在當(dāng)?shù)亻_(kāi)展的宮頸癌篩查項(xiàng)目的高危型HPV陽(yáng)性患者進(jìn)行隨訪，8-12個(gè)月后再次進(jìn)行HPV檢測(cè)，隨機(jī)選取其中仍為陽(yáng)性者70例，轉(zhuǎn)陰者20例。本實(shí)驗(yàn)采用Cervista HPV HR檢測(cè)方法檢測(cè)宮頸脫落細(xì)胞中14種高危型HPV的感染情況，陽(yáng)性結(jié)果分為三組：A5/A6組（51，56，66型）、A7組（18，39，45，59，68型）、A9組（16，31，33，35，52，58型）。HPV陽(yáng)性者包括A9組高危型HPV感染者20例，A7組15例，A5/A6組15例以及混合感染組20例。所有患者均在知情同意的情況下行陰道鏡檢查，并取宮頸組織活檢，常規(guī)送組織病理學(xué)檢查。采用熒光原位雜交技術(shù)檢測(cè)宮頸組織中hTERC基因的表達(dá)情況。 根據(jù)宮頸組織感染HPV亞型分組其結(jié)果為:hTERC基因在HPV轉(zhuǎn)陰宮頸組織的陽(yáng)性率為5%；在A5/A6，A7，A9及混合感染組的陽(yáng)性率分別為：33.33%，53.33%，85%及50%；A9組hTERC基因擴(kuò)增與對(duì)照組、A5/A6組、A7組及混合感染組比較有統(tǒng)計(jì)學(xué)差異（P＜0.05）。根據(jù)組織病理學(xué)結(jié)果分組：hTERC基因在正常宮頸組織或炎癥組、CIN1組、CIN2組及CIN3組的陽(yáng)性率分別為：13.79%，，33.33%，66.67%及93.75%。hTERC基因在正常宮頸組織或炎癥及CIN1組中的擴(kuò)增與CIN2組、CIN3組比較有統(tǒng)計(jì)學(xué)差異（P＜0.05）。 綜上所述，宮頸組織中hTERC基因的擴(kuò)增與感染HPV亞型相關(guān)，與A9組感染關(guān)系密切。隨著宮頸病變的進(jìn)展，hTERC基因的擴(kuò)增呈遞增趨勢(shì)。hTERC基因?qū)τ谠\斷宮頸病變的級(jí)別及預(yù)測(cè)宮頸病變的進(jìn)展具有一定的臨床意義。
[Abstract]:Cervical cancer is the second largest malignant tumor that endangers women's health. In recent years, the incidence and mortality of cervical cancer have been improved significantly, thanks to the development of cervical cancer screening, so the screening method of cervical cancer is particularly important. Persistent HR-HPV infection is the leading cause of cervical cancer, this view has been widely accepted. In about 70% of cervical cancer, the abnormal chromosome of chromosome 3 is mainly characterized by abnormal amplification of the long arm of chromosome 3, and the human telomerase gene hTERC is located in this region. This study was to investigate the expression and clinical significance of hTERC gene in cervical tissues infected with different subtypes of HPV. High-risk HPV positive patients in Chicheng County, Hebei Province from August to October 2012, who participated in the local cervical cancer screening project of the first affiliated Hospital of Hebei North University, were followed up for 8 to 12 months for HPV test again. Among them, 70 cases were still positive and 20 cases were negative. Cervista HPV HR was used to detect 14 kinds of high-risk HPV infection in cervical exfoliated cells. The positive results were divided into three groups: 1 / A5 / A6 group: 15 cases in A7 group and 15 cases in A7 group and 20 cases in A7 group, 15 cases in A7 group and 20 cases in A7 group as well as 20 cases in mixed infection group. All patients underwent colposcopy with informed consent, biopsy of cervical tissue and routine histopathological examination. The expression of hTERC gene in cervical tissues was detected by fluorescence in situ hybridization. According to the HPV subtype of cervical infection, the positive rate of hTERC gene was 55.The positive rate of hTERC gene in A5 / A6A7A9 and mixed infection group was 55.33% and 53.33%, respectively, and the positive rate of hTERC gene in A5 / A6 group and A7 group was 85% and 53.33%, respectively, compared with control group A5 / A6 group and mixed group A7 group. There was significant difference between the two groups (P < 0.05). According to the histopathological results, the positive rates of 93.75%.hTERC gene in normal cervix or inflammation group were 66.67% in CIN2 group and 66.67% in CIN2 group and CIN3 group, respectively. The amplification of 93.75%.hTERC gene in normal cervix or inflammation and CIN1 group was significantly different from that in CIN2 group (P < 0.05). To sum up, the amplification of hTERC gene in cervical tissues was related to the subtype of infected HPV, and was closely related to the infection of A9 group. With the progress of cervical lesions, the amplification of hTERC gene shows an increasing trend. It is of clinical significance to diagnose the grade of cervical lesions and predict the progress of cervical lesions.
【學(xué)位授予單位】：河北北方學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.33

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王曉華;蘇秀蘭;;hTERC基因擴(kuò)增與宮頸病變的相關(guān)性研究[J];包頭醫(yī)學(xué)院學(xué)報(bào);2010年01期

2 劉繼秀;林志新;陳科;;FISH技術(shù)檢測(cè)宮頸上皮細(xì)胞中hTERC基因擴(kuò)增的臨床研究[J];廣西醫(yī)科大學(xué)學(xué)報(bào);2010年02期

3 晁宏圖;馮曉杰;馬杰;孫淼淼;羅艷林;魏麗惠;王莉;;FISH技術(shù)檢測(cè)宮頸病變中hTERC基因的表達(dá)及意義[J];河南醫(yī)學(xué)研究;2010年03期

4 史佃云;陳賽英;李桂梅;;hTERC基因檢測(cè)對(duì)篩查高危子宮頸病變預(yù)防宮頸癌的臨床意義[J];臨床腫瘤學(xué)雜志;2011年11期

5 林志新;陳科;閆芳;劉繼秀;;人端粒酶RNA基因擴(kuò)增和高危型HPV感染檢測(cè)對(duì)宮頸癌及宮頸上皮內(nèi)瘤變的預(yù)測(cè)意義[J];實(shí)用婦產(chǎn)科雜志;2010年11期

6 申艷;闞延靜;華荃;;人染色體端粒酶基因的擴(kuò)增率與宮頸癌前病變和宮頸癌的研究[J];實(shí)用婦產(chǎn)科雜志;2011年06期

7 黃斌;李瑞珍;吳瑞芳;湯惠茹;劉志紅;烏蘭娜;李鵑;王純;周艷秋;翁雷明;;HPV L1殼蛋白與hTERC基因檢測(cè)及聯(lián)合分析對(duì)宮頸癌篩查的意義[J];華中科技大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2010年04期

8 楊維娜;尹利榮;段青;馬鴻達(dá);;宮頸上皮內(nèi)瘤變治療前后hTERC基因表達(dá)結(jié)果分析[J];天津醫(yī)藥;2010年08期

9 歐亞夢(mèng)蘭;高琨;;人端粒酶RNA組份基因與宮頸病變的研究進(jìn)展[J];中國(guó)癌癥防治雜志;2011年03期

10 管愛(ài)芳;;TCT聯(lián)合HPV檢測(cè)在宮頸癌篩查中的臨床應(yīng)用[J];中國(guó)社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2012年09期

本文編號(hào)：1875320