摘要目的 探讨高危型人乳头状瘤病毒(HR-HPV)阳性子宫颈脱落细胞中人乳头状瘤病毒L1(HPVL1)及人端粒酶RNA(hTERC)基因的表达及其与子宫颈病变的相关性.方法 选择有子宫颈活组织检查结果的HR-HPV阳性子宫颈脱落细胞学标本300例,其中子宫颈活组织检查结果为正常及慢性炎症46例、子宫颈上皮内瘤变(CIN)Ⅰ 95例、CINⅡ58例、CINⅢ64例、子宫颈鳞状细胞癌(SCC)37例.采用免疫细胞化学MaxVision法检测液基细胞学标本中抑癌基因HPVL1的表达,用荧光原位杂交技术(FISH)检测子宫颈脱落细胞中hTERC基因的扩增水平.结果 HPVL1阳性率在正常及慢性炎症、CIN Ⅰ、CINⅡ、CINⅢ及SCC组中分别为58.70％(27/46)、63.16％(60/95)、37.93％(22/58)、10.94％(7/64)、0(0/37),随着子宫颈病变恶性程度的增高,HPVL1阳性率逐渐降低.hTERC扩增阳性率在正常及慢性炎症、CIN Ⅰ、CINⅡ、CINⅢ、SCC组中分别为6.52％(3/46)、11.58％(11/95)、51.72％(30/58)、85.94％(55/64)、100.00％(37/37),与子宫颈病变的严重程度呈正相关(rs=0.302,P＜ 0.01).HPVL+/hTERC-在CIN Ⅰ中占57.89％,在CINⅢ中占4.69％;HPVL1-/hTERC+在CIN Ⅰ中占6.32％,CINⅢ中占79.69％.结论 联合检测HPVL1及hTERC在HR-HPV阳性子宫颈病变的诊断中具有重要的作用.

abstractsObjective To evaluate the significance of human papillomavirus L1 capsid protein (HPVL1) and human telomerase RNA component (hTERC) gene in the cytologic specimens of cervix which was infected by the high-risk types of human papillomavirus (HR-HPV),and to expose their relationship with cervical lesions.Methods The fluorescence signal of cytologic samples of cervix were detected by interphase FISH in chromosome enumeration double-color DNA probes TERC.The expression of HPVL1 capsid protein was detected by MaxVision immunohistochemistry method.300 samples were analyzed with HR-HPV positive from the cervical biopsy.The diagnoses as normal or chronic inflammation (n =45),cervical intraepithelial lesions Ⅰ grade (CIN Ⅰ,n =95),CIN Ⅱ (n =58),CIN Ⅲ (n =64),and squamous cervical cancer (SCC,n =37).Results The percentage of HPVL1 positive rates in normal or chronic inflammation,CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC groups were 58.70 ％ (27/46),63.16 ％ (60/95),37.93 ％ (22/58),10.94 ％ (7/64) and 0 (0/37),respectively.The percentage of HPVL1 decreased along with the increase of severity of the cervical intraepithelial lesions.Genomic amplification of hTERC positive rates in normal or chronic inflammation,CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC groups were 6.52 ％ (3/46),11.58 ％ (11/95),51.72 ％ (30/58),85.94 ％ (55/64) and 100.00 ％ (37/37),respectively.The percentage of hTERC increased along with the severity of the cervical intraepithelial lesions (rs =0.302,P ＜ 0.01).The percentage of HPVL+/hTERC-was 57.89 ％ in CIN Ⅰ group and 4.69 ％ in CIN Ⅲ group.The percentage of HPVL-/hTERC+ was 6.32 ％ in CIN Ⅰ group and 79.69 ％ in CIN Ⅲ group.Conclusion The detection of HPVL1 and hTERC are important for assisting cervical lesions screening and monitoring of disease progression in the HR-HPV positive cytologic specimens.