hTERC基因在持续性HPV感染的宫颈组织中的表达及其临床意义

发布时间：2018-05-11 19:36

本文选题：宫颈病变 + 人乳头瘤病毒　；参考：《河北北方学院》2014年硕士论文

【摘要】：宫颈癌是危害女性健康的第二大恶性肿瘤，近年来宫颈癌的发病率及病死率得到显著改善，得益于宫颈癌筛查工作的开展，由此可见宫颈癌的筛查方法显得尤为重要。持续性HR-HPV感染是导致宫颈癌发生的主要致病原因，这一观点已得到普遍公认。在大约70%的宫颈癌中，其染色体异常主要表现为3号染色体长臂的异常扩增，人类染色体端粒酶基因（hTERC）位于此区域。本研究探讨hTERC基因在不同亚型HPV感染宫颈组织中的表达及其临床意义。通过对2012年8月至10月河北省赤城县参加河北北方学院附属第一医院妇产科在当地开展的宫颈癌筛查项目的高危型HPV阳性患者进行随访，8-12个月后再次进行HPV检测，随机选取其中仍为阳性者70例，转阴者20例。本实验采用Cervista HPV HR检测方法检测宫颈脱落细胞中14种高危型HPV的感染情况，阳性结果分为三组：A5/A6组（51，56，66型）、A7组（18，39，45，59，68型）、A9组（16，31，33，35，52，58型）。HPV阳性者包括A9组高危型HPV感染者20例，A7组15例，A5/A6组15例以及混合感染组20例。所有患者均在知情同意的情况下行阴道镜检查，并取宫颈组织活检，常规送组织病理学检查。采用荧光原位杂交技术检测宫颈组织中hTERC基因的表达情况。根据宫颈组织感染HPV亚型分组其结果为:hTERC基因在HPV转阴宫颈组织的阳性率为5%；在A5/A6，A7，A9及混合感染组的阳性率分别为：33.33%，53.33%，85%及50%；A9组hTERC基因扩增与对照组、A5/A6组、A7组及混合感染组比较有统计学差异（P＜0.05）。根据组织病理学结果分组：hTERC基因在正常宫颈组织或炎症组、CIN1组、CIN2组及CIN3组的阳性率分别为：13.79%，，33.33%，66.67%及93.75%。hTERC基因在正常宫颈组织或炎症及CIN1组中的扩增与CIN2组、CIN3组比较有统计学差异（P＜0.05）。综上所述，宫颈组织中hTERC基因的扩增与感染HPV亚型相关，与A9组感染关系密切。随着宫颈病变的进展，hTERC基因的扩增呈递增趋势。hTERC基因对于诊断宫颈病变的级别及预测宫颈病变的进展具有一定的临床意义。
[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.
【学位授予单位】：河北北方学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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