Clinical Analysis And Expression Of Human Telomere Gene Of 120 Cases With Cervical Lesions

Object: Cervical cancer is one of the primary malignant tumor which is endangering women's health in the world. It is second only to breast cancer in gynecology. According to statistics the number of new cases of cervical cancer was 465 thousands every year all over the world,of which 80% of cases occur in the developing countries. One-fifth of the total new cases occur in our country each year. With the popularity of cervical cancer screening, cervical cancer and precancerous lesions enable early detection and treatment can be.In recent years, The morbidity of cervical showed a younger trend in our country. The incidence and mortality of cervical cancer has declined .The proportion of early stage cervical cancer increased. Cervical cytology screening, colposcopy biopsy and histopathological examination are effective diagnostic procedures to diagnose cervical lesions step by step. Cervical cytology is the primary method of screening. It is simple and easy, but it has a higher false-positive or false-negative rate. Colposcopy biopsy screening and histopathological examination cannot become normol methods of cervical lesions because of their invasion. Thus,there is an urgent need of new ways to make the cervical screning more accurate, reliable and more predictable. Morden cell genetics and molecular biology studies have shown that the majority of hunman tumor cells express chromosome instability, especially for silid tumors. Chromosome instability include changes in chromosome number and abnormalities in chromosome structure. During the process of atypical cervical cells to cervical cancer, almost all cervical cells accompany the amplification of the long arm of chromosome 3. The most important gene related to the long arm of chromosome 3 may be the hunman telomerase gene. The study is to discuss the onset age, clinical features, screening methods and the telomerase activity. Fluorescence in situ hybiridization (FISH) can detect cytogenetic abnormalities in the early stage. The technology is the genetic diagonosis with minimal impact of subjective factors. So it can be used as a useful biological target for the prevention and screening of cervical lesions.Methods: Cervical specimens from 120 patients were obtained from the First ,Second hospital of Jilin university and Cancer hospital of Jilin Province. According to histology biopsy, 120 specimens were divided into 5 groups: normal(n=20), cervical intraepithelial neoplasia I (CINI,n=23), cervical intraepithelial neoplasia II (CINII,n=21), cervical intraepithelial neoplasia III (CINIII,n=23), squamous caicinomas of the cervix(SCC, n=33). The study is to discuss the onset age, clinical features, screening methods and the telomerase activity. The fluorescent signals in cytological samples of the cervix are detected by using interphase FISH with the dual-color TERC probe. Under the fluorescence microscope, we count 100 cells with signal intergrity. The nucleus appears red signals>5 for the positive. Positive means TERC gene amplification. Result: The amount of cervical intraepithelial neoplasia is 67cases, with 25-35-year-old group the majority, accounting for 53.73%, followed by 35-45 year old, accounting for 23.88%; 33 cases of cervical cancer patients, with 35-45-year-old group the majority, accounting for 63.64%, followed by 45-55-year-old group, accounting for 21.21%. Among the 67 cases of cervical intrepithelial neoplasia, 26 cases of asymptomatic(38.8%), 23 cases of contact bleeding and irregular vaginal bleeding(34.3%), 13 cases of abnormal discharge(19.4%), 4 cases of abdominal pain or back pain and 1 case of frequent urination or urinating blood. Cervical appearance: 22 cases of smooth, 45 cases of ectopic cervical columnar epithelium. Among the 33 cases of cervical cancer, all patients were treated because of contact bleeding, irregular vaginal bleeding or abnormal discharge. Cervical appearance: 1 case of ectopic cervical columnar epithelium and 32 cases of hyperplasia. The number of preoperative cervical smears consistent with the pathological diagnosis is 81 cases (81%) and colposcopy fully consistent with pathological diagnosis is 85 (85%). Normal cervical tissue has non-positive expression of telomerase, the positive rate of telomerase in CINI is 8.7% (2cases), in CINII is 71.43% (15cases), in CINIII is 69.57% (16cases), in SCC is 100%(33cases).Conclusion: 1. Cervical intraepithelial neoplasia mainly occurred at ages 25-35, and cervical cancer usually happened at ages 35-45 . 2. Patients of CIN usually have no clinical symptoms, so most patients with cinical treatment were founded in later stage of cervical cancer. Most patients of cervical cancer were examinated and treated because of contact bleeding , irregular vaginal bleeding or abnormal discharge. 3. Colposcopy and TCT are of high value in diagnosis of early cervical lesions. They have no significant difference in the rate of pathological diagnosis. To combine these two methods can improve the rate of diagnosis of cervical lesions. 4.TERC gene is highly expressed in high-grade squamous intraepithelial lesion and squamous cells carcinoma of cervix. With the progress of cervical lesions, the amplification of the TERC gene shows an increasing trend.