| Careinoma of the uterine cervix that we are usually to see is the seeond commonest female cancer in the world,which only inferior to breast cancer.The prevalence lies in first plaee in our country and beeome one of the main disease which severely threaten health of women in our country.At present cervical cancer's screening mainly includes the cervix cytology and the HPV examination,but each method has the limitation,therefore we need to find other reliable method assist the inspection urgently.The numerous researched indicated that the human majority malignant tumors occur often concern with the chromosome instability.Some research discoveried the human telomerase is the early event in the development of cervical cancer.There have been close relations between the human telomerase activation degree and the cervical lesions degree.The TERC gene mapping in three chromosome long arms(3q,26.3),mainly codes the human telomeraseRNA,which is one of the human telomerase activity essential components.So detect the TERC gene will helpful to cervical cancer's screening and the early diagnosis.At present,the standard method to examine gene is fluorescence in situ hybridization (FISH).This topic plans through the FISH technology to examine the TERC gene in varying degrees of cervical lesions,and provides the new way to the early diagnosis and prognosis appraisal of the cervical cancer.Purpose:To evaluate the value of liquid-based thin-layer cytology test,and using the FISH technology to examine the TERC gene in varying degrees of cervical lesions,and provides the new way to the early diagnosis and prognosis appraisal of the cervical cancer.Method:To analyse and summarize 4285 cases of patients,who voluntary to checkup TCT test in the First Hospital Affiliated of Shanxi Medical University from June.2008 to January.2009.Among them,the TCT test abnormal(i.e.:according toTBS system the pathological change above ASCUS)have 462 examples,which makes colposcopy test and takes the biopsy to carry on the pathological diagnosis have 405 examples.Take the pathology as the golden standard,carries on the comparative analysis with the fluid basal cell study result.And extracted 100 examples at random in the above 405 specimens divides into ASCUS,LSIL,the HSIL three groups,at the same time extracted 20 examples in the TCT test normal groups at random.Using the FISH technology checkup the TERC gene of each group and observes the change tendency between the cervical lesions degree development and the TERC gene expression situation,and carries on the comparison to the TCT inspection and the TERC gene examination.All status was measured by a chi-square test and using the sensibility,specificity, predictive value of the positive test,predictive value of the negative test,the rate of missed diagnosis,the misdiagnosis rate and the coincidence rate to evaluate the value of TCT test and the FISH technology.Content:1.we collected TCT specimen 4285 examples,among them have 462 examples abnormal, the detection rate is 10.78%.The ASCUS/AGUS have 268 examples(the ratio is 6.25%),LSIL have 133 examples(the ratio is 3.10%),HSIL have 61 examples,(the ratio is 1.42%).There have 405 examples makes colposcopy test and takes the biopsy to carry on the pathological diagnosis. Take the pathology inspection as the golden standards,each group of detection are ASCUS 25.09%(63/251),LSIL 62.36%(58/93),HSIL 96.29%(52/54),CC 100%(7/7).The TCT test to CINâ…¡have sensitivity of 62.5%,specificity of 98.11%,predictive value of the positive test 90.16%and predictive value of the negative test 90.41%,and the rate of missed diagnosis is 37.5%,the misdiagnosis rate is 9.84%,the coincidence rate is 85.43%;The TCT test to CINâ… have sensitivity of 39.02%,specificity of 84.30%,predictive value of the positive test 47.76% and predictive value of the negative test 78.99%,and the rate of missed diagnosis is 60.98%the misdiagnosis rate is 52.24%,the coincidence rate is 72.13%.2.Using the FISH technology test the 20 examples which TCT check result normal specimen to judge the threshold value which the TERC gene masculine gender increases is 10%. We found in the ASCUS group,the TERC gene masculine gender rate is 19.51%,the LISL group is 34.29%,the HSIL group is 91.03%.According to the pathology result,we found in histology normal group,the TERC gene masculine gender rate respectively is 8.47%,CINâ… group is 21.43%,CINâ…¡group is 40%,CINâ…¢group is 78.78%,the cervical cancer group is 100%.The the FISH technology checkup the TERC gene to CINâ…¡have sensitivity of 72.34%,specificity of 89.04%,predictive value of the positive test 80.95%,and predictive value of the negative test 83.33%,and the rate of missed diagnosis is 27.66%,the misdiagnosis rate is 19.05%,the coincidence rate is82.5%;The FISH technology checkup the TERC gene to CINâ… have sensitivity of 21.42%,specificity of 91.53%,predictive value of the positive test 37.5%and predictive value of the negative test 83.07%,and the rate of missed diagnosis is 78.57%the misdiagnosis rate is 62.5%,the coincidence rate is 78.08%.3.Comparedthe TCT test and the FISH technology checkup the TERC gene,we foun that the FISH technology checkup the TERC gene diagnosis cervical lesions's specificity,predictive value of the positive test,predictive value of the negative test,the total coincidence rate are higher than the TCT test,the misdiagnosis rate are lower than the TCT test.Conclusion:1.The degree of cervical lesions is higher,the consistent of TCT test is higher. 2.The TERC gene expresses in the cervical precancerous lesion and cervical cancer.The expression rate of FISH technology checkup the TERC gene increase along with the increases of pathological change degree.3.Compares the FISH technology checkup the TERC gene with the TCT test,we found the sensitivity,specificity of the FISH technology checkup the TERC gene is high,the misdiagnosis rate are lower than the TCT test,has the higher diagnosis value.4.The FISH technology checkup the TERC gene maybe a biological indicator to monitor the Progress of cervical lesions. |
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