The Expression Of Hterc Gene In Different Grades Of Cervical Lesions.

Objective:To investigate the expression of hTERC gene in the cervical exfoliated cells, determine its value in diagnostic of cervical intraepithelial neoplasia (CIN) and cervical cancer andobserve the association of hTERC gene expression and progression of cervical cancer by following up.Methods:204 patients were all examined with liquid-based cytology (LCT), high-risk human papilomavirus (HR-HPV) test by hybrid captureⅡ(HC-Ⅱ) and hTERC gene detection by Fluorescence in situ Hybridization (FISH) in China-Japan Friendship Hospital from December 2007 to May 2009. All patients were devided into 5 groups according to pathology:normal cervical epithelium/cervicitis (control group,33 cases), CINⅠ(76 cases), CINⅡ(31cases), CINⅢ(including carcinoma in situ,35 cases), and invasive cervical squamous-cell carcinoma (SCC,29 cases).After 6 months,30 patients with cytological grade lower than HSIL were chosen to perform LCT and hTERC gene detection by FISH.Results:The number of normal, CINⅠ,Ⅱ,Ⅲand cervical cancer were 33,76,31,35,29 respectively. There were significant difference of hTERC gene expression in different grades (P<0.01):(1) In cytological groups, there was a differently increase of hTERC gene expression in patients with HSIL and higher grades (P＜0.01).(2) In histological groups, there was a differently increase of hTERC gene expression in patients with CINⅡand higher grades (P＜0.01).(3)The hTERC gene detection rates were increased in different grades of cytological and histological groups.(4) The detection rate of HR-HPV-DNA was positively correlated with the increase of pathological grades of cervical lesions.(χ2=117.943, P＜0.01; Kendall coefficient of rank correlation, tau-b=-0.575, P＜0.01); The patients with both hTERC gene expression and HR-HPV positive were increased in higher grades of cytological and histological groups. (χ2=107.538, P＜0.01; Kendall coefficient of rank correlation, tau-b=-0.592, P＜0.01)。The 8 progressed patients were devided into 2 groups cytologically:ASC and LSIL.7 of them were in hTERC gene expression group. In dynamic observation of cervical lesion, the advanced cytological diagnoses were correlated with hTERC gene expression. In dynamic observation of cervical lesion, the advanced cytological diagnoses were correlated with higher hTERC gene expression.Conclusion:Expression of hTERC gene has a tight correlation with the histology and cytology of cervical lesion. It increased progressively with the more severe lesion of cervix. It maybe one of diagnostic indicators to judge high grade lesion, and have prognostic values.Expression of hTERC gene has correlation with HR-HPV infection which indicates that HR-HPV infection may induce high expression.High expression of hTERC gene presents disease progressing. It will show the variation of chromosome and reflect the pathological tendency.The patients without experssion of hTERC gene could be deal with follow-up regularly and conservative treatment.hTERC gene may be a biological marker for diagnosis and prognosis.