宮頸病變中hTERT與高危型HPV感染關(guān)系的相關(guān)研究
發(fā)布時(shí)間:2018-11-24 13:43
【摘要】:目的: 探討人端粒酶逆轉(zhuǎn)錄酶(hTERT)和高危型人乳頭瘤病毒(HR-HPV)感染在宮頸病變中的關(guān)系,探討應(yīng)用FISH技術(shù)檢測宮頸脫落細(xì)胞中hTERT基因?qū)m頸癌前病變篩查的價(jià)值,探討通過實(shí)時(shí)熒光定量RT-PCR檢測血清中hTERT mRNA水平預(yù)測HR-HPV感染的危險(xiǎn)性。 方法: 1.選取天津醫(yī)科大學(xué)第二醫(yī)院婦科陰道鏡下多點(diǎn)活檢病理組織學(xué)檢查診斷為正常宮頸的34例,31例宮頸上皮內(nèi)瘤變(CIN)Ⅰ級,33例CIN Ⅱ級,34例CIN Ⅲ級,20例宮頸癌患者的宮頸脫落細(xì)胞及血清標(biāo)本。 2.應(yīng)用聚合酶鏈反應(yīng)(PCR)-反向雜交芯片法檢測宮頸脫落細(xì)胞中HPV DNA陽性情況。 3.應(yīng)用熒光原位雜交技術(shù)(FISH)檢測宮頸脫落細(xì)胞中hTERT基因擴(kuò)增情況。 4.應(yīng)用實(shí)時(shí)熒光定量RT-PCR技術(shù)檢測血清中hTERT mRNA表達(dá)水平。 5.評估hTERT在輔助診斷宮頸癌前病變中的價(jià)值,預(yù)測HR-HPV感染的風(fēng)險(xiǎn)性,為CIN的篩查提供更為準(zhǔn)確、可靠、更有預(yù)見性的新指標(biāo)。結(jié)果: 1.共檢出20種HR-HPV HPV16,18,26,31,33,35,39,45,51,52,53,56,58,59,66,67,68,69,73,82。隨著宮頸組織學(xué)病變程度的加重,HR-HPV感染率逐漸增高(P<0.05), CIN Ⅱ級(72.73%)、CIN Ⅲ級(85.29%)、宮頸癌組(90.00%)的HR-HPV DNA陽性比例高于對照組(20.59%),對照組與CIN Ⅰ級(54.84%)組比較差異無統(tǒng)計(jì)學(xué)意義(P0.005)。 2.隨著宮頸病變程度的加重,hTERT基因擴(kuò)增陽性率逐漸升高(P0.05),宮頸癌組(80.00%)hTERT基因擴(kuò)增的陽性率高于對照組(0)、CIN Ⅰ級(3.22%)、CIN Ⅱ級(18.18%),宮頸癌與CIN Ⅲ級組(41.18%)比較差異無統(tǒng)計(jì)學(xué)意義(P0.005)。 3.所有宮頸脫落細(xì)胞中hTERT基因出現(xiàn)異常擴(kuò)增的患者血清中hTERT mRNA均陽性,而hTERT基因無異常擴(kuò)增的患者血清中hTERT mRNA均陰性。 4.hTERT基因擴(kuò)增、mRNA陽性與HR-HPV感染呈正相關(guān)(r=0.238,P0.05)。宮頸癌、CIN III級、CIN II級每個(gè)組中HR-HPV陽性的hTERT mRNA水平高于HR-HPV陰性(P0.05)。 5.隨細(xì)胞學(xué)病變程度的加重,hTERT基因擴(kuò)增及mRNA陽性率逐漸增高(P0.05),癌組(80.00%)的陽性率高于NSIL (0)、ASC (0)、LSIL (2.7%)、 HSIL(28.6%), NSIL與ASC組比較差異無統(tǒng)計(jì)學(xué)意義(P0.005)。 6.3種檢測結(jié)果(TCT、HPV、hTERT)比較:hTERT檢測的特異性均高于HPV和TCT檢測,可以彌補(bǔ)HPV、TCT特異性較低的不足。 結(jié)論: 1. hTERT檢測可能作為篩查宮頸癌及其癌前病變的分子標(biāo)志,應(yīng)用于臨床早期宮頸病變的診斷中。 2.宮頸病變中hTERT基因擴(kuò)增及表達(dá)與HR-HPV感染呈正相關(guān),HR-HPV感染可能是hTERT基因異常擴(kuò)增及表達(dá)的早期事件,檢測hTERT可能預(yù)測HR-HPV感染的風(fēng)險(xiǎn)性。
[Abstract]:Objective: to investigate the relationship between human telomerase reverse transcriptase (hTERT) and high-risk human papillomavirus (HR-HPV) infection in cervical lesions. To explore the value of detecting hTERT gene in exfoliated cells of cervix by FISH technique in screening for cervical precancerous lesions and to predict the risk of HR-HPV infection by real-time fluorescence quantitative RT-PCR detection of hTERT mRNA level in serum. Methods: 1. 34 cases of normal cervix were selected from gynecologic colposcopy of the second Hospital of Tianjin Medical University, 31 cases of cervical intraepithelial neoplasia (CIN) 鈪,
本文編號:2353941
[Abstract]:Objective: to investigate the relationship between human telomerase reverse transcriptase (hTERT) and high-risk human papillomavirus (HR-HPV) infection in cervical lesions. To explore the value of detecting hTERT gene in exfoliated cells of cervix by FISH technique in screening for cervical precancerous lesions and to predict the risk of HR-HPV infection by real-time fluorescence quantitative RT-PCR detection of hTERT mRNA level in serum. Methods: 1. 34 cases of normal cervix were selected from gynecologic colposcopy of the second Hospital of Tianjin Medical University, 31 cases of cervical intraepithelial neoplasia (CIN) 鈪,
本文編號:2353941
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