The Expression And Significance Of HTERC Gene In Cervical Intraepithelial Neoplasia Prior And Post Treatment

Objective:The purpurse of this study was to detect the expression of hTERC gene in cervical intraepithelial neoplasia,to analyze the relationship between the amplification of hTERC gene and cervical intraepithelial neoplasia(CIN),and compared with HPV and TCT detection,evaluating the possibility of FISH in detecting CIN and forecasting the prognoses,providing a new way which is more accurate,reliable and foreseeable.Method:A series of 40 CIN including 14 CINⅠ,16 CINⅡand 10 CINⅢ,who were preliminarily diagnosed by biopsy under the colposcopy in the department of gynecology of the second affiliated hospital of Tianjin medical university.14 CINⅠand 16 CINⅡwere subjected to LEEP.10 CINⅢ,6 of them were subjected to hysterectomy,the other of them were subjected to conization of cervix.Before treatment all of them were detected the expression of hTERC gene applying fluorescence in situ hybridization(FISH),at the same time detected by HPV and TCT. All of them were followed-up for 6 to 12 months,except whom were subjected to hysterectomy.6 months after treatment they were detected by FISH,HPV,TCT and biopsy under the colposcopy once more.And dealing with them on the basis of pathology.The abnormal biopsies findings were further under LEEP.Evaluating the possibility and validity of FISH in detecting CIN and forecasting residual CIN.Results:①In all CIN groups,the percentage of cells with amplification of hTERC gene increased with the severity of the histologic interpretation(all P＜0.05).The positive expression intensity of hTERC gene were increased also.The result comparing CINⅠwith CINⅢgroup had a significant difference(all P＜0.01),in both negative and strongly positive group.②The percentage of cells with amplification of hTERC gene was obviously lower than prior treatment(P＜0.01).And the positive expression rate was decreased also.The positive expression of hTERC gene was major in prior treatmen group,in post-treatment group the negative expression was major,there was a significant difference(P＜0.01).③The result of the residual rate comparing strongly positive group with negative,weakly positive and moderately positive group had a significant difference(P＜0.05).④Comparing hTERC gene with TCT detection,the result comparing normal cytology group with LSIL group,normal cytology group with HSIL group,ASC group with HSIL group and LSIL group with HSIL group separately had a significant difference(all P＜0.01).The expression of hTERC gene increased with the severity of the cytologic interpretation,they had positive correlation(r=0.784,P＜0.01).⑤Comparing hTERC gene with HPV detection,the positive detection rate of hTERC gene detection was approaching to HPV detection in all CIN groups(all P＞0.05).⑥Comparing among the 3 detection, the sensitivity,specificity,PPV,NPV,Younden's index and crude agreement rate of hTERC gene detection were better than HPV and TCT detection.The compositive effect of hTERC gene detection was better than TCT and HPV detection,and it can make up the disadvantage of them.Conclusion:①The percentage of cells with amplification of hTERC gene increased with the severity of the histologic interpretation,and the positive intensity of the hTERC gene expression increased also.Maybe the abnormal amplification of hTERC gene is the early incident in the process of forming cancer of the cervix.It could be molecule marker in screening uterine cancer and precancerous change.②Detecting the copy number of hTERC gene using FISH may be helpful for auxiliary diagnosis of CIN,and the operation of FISH is relatively simple,the result is more objective, the reproducibility,stabilization,sensitivity and specificity are better,it is more fit for detecting precancerous change.③The detection of hTERC gene has important value in predicting the risk of residual disease and could be effective in the follow-up treatment.The cases who have stronger positive expression of hTERC gene have large recurrent risk,and should be followed frequently.