FISH检测宫颈脱落细胞与宫颈组织中hTERC基因制片方法的研究

目的:探讨FISH实验中用直接涂片法、盐水制片法、TCT制片法、低渗滴片法制片法和宫颈切片组织取材方法对于FISH成功率的影响.方法:收集2008年3月至2009年3月青岛大学医学院附属医院妇科162例宫颈脱落细胞标本及2008年5月至2009年3月手术切除或活检的宫颈组织63例,用荧光原位杂交(FISH)方法检测hTERC基因.结果:直接涂片法、盐水制片法、生理盐水法、TCT制片法和石蜡包埋组织切片法hTERC基因杂交成功率分别为58.3%,65%,55%,87.1%,85.7%,TCT制片高于其它四组;低渗滴片法背景干净度、细胞形态、裸核数量满意度最高;TCT制片法细胞数量满意率最高;石蜡包埋组织切片法荧光信号满意率最高.结论:在检测hTERC基因的宫颈癌筛查中,TCT制片法明显优于其他方法,而在指导宫颈病变及宫颈癌的治疗中,石蜡包埋组织切片法的染色体破坏最小,实际意义更大.     

50例非典型腺细胞病理结果分析

目的:分析宫颈细胞学诊断为非典型腺细胞(AGC)病例的病理结果,探讨AGC诊断的临床意义。方法:通过宫颈细胞学的检查对非典型腺细胞病例的宫颈组织病理检查进行归纳分析。结果:50例病例中宫颈炎19例,CINⅠ14例;CINⅡ6例;CINⅢ9例,其中1例累及腺体;宫颈鳞状细胞癌2例。结论:AGC的诊断常提示宫颈上皮内瘤样病变,同时对于细胞学诊断AGC的病例的病人进行跟踪随访并进行规范化临床处理。     

宫颈脱落细胞中HCCR的表达及意义

目的研究人宫颈癌基因(HCCR)在宫颈脱落细胞中的表达情况,探讨其对宫颈癌及癌前病变诊断的意义。方法采用Western blot及免疫组化SP法对79例宫颈脱落细胞中HCCR蛋白进行检测,其中正常宫颈上皮脱落细胞11例、宫颈上皮内瘤样病变(CIN)53例、宫颈癌(CCa)15例。所有标本均来自中国医科大学附属第一医院。结果HCCR基因在正常宫颈脱落细胞中不表达或阳性率较低,在宫颈上皮内瘤变及宫颈癌中表达阳性率随病变加重而逐级升高。结论HCCR与宫颈上皮内瘤变及宫颈癌的发生密切相关,检测宫颈脱落细胞中HCCR蛋白的水平对宫颈癌的筛查和诊断可能具有重要意义。     

P16/Ki-67细胞学双染在TCT诊断为非典型鳞状细胞意义不明确(ASC-US)中的分流作用研究

目的:分析P16/Ki-67双染在TCT(Thinprep cytologic test)诊断为非典型鳞状细胞,意义不明确(Atypical Squamous Cells of Undetermined Significance,ASC-US)的患者分流中的作用。方法:选取2016年9月-2018年9月在我院经宫颈液基细胞学检查诊断为ASC-US的434例女性患者为研究对象,采用P16/Ki-67双染、高危型HPV(High-Risk human papillomavirus,HR-HPV)检测,对比二者与宫颈组织学活检结果的相关性,并分析二者在ASC-US患者分流中的作用。结果:P16/Ki-67细胞学双染法的敏感性为78.2%,特异性为79.2%,HR-HPV法的敏感性为33.5%,特异性为62.3%。P16/Ki-67细胞学双染法在年轻组患者中检出高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)及以上病变的敏感性为94.5%,特异性为85.7%;在年长组患者中敏感性为44.4%,特异性为74.3%。结论:P16/Ki-67细胞学双染作为一种临床应用简单、患者易于接受、价格相对低廉的生物学标志物,为宫颈癌的早期筛查提供了新的选择。同时,对于年轻患者,P16/Ki-67双染用于ASC-US的分流比HR-HPV检测具有更高的临床应用价值。     

采用PCR-测序法对北京地区325例妇女宫颈脱落细胞样品中人乳头瘤病毒进行检测和基因分型

为了探讨PCR-测序法在宫颈脱落细胞样品中人乳头瘤病毒 (Human papillomavirus, HPV) 临床检测中的应用价值,采用HPV通用引物PGMY09/11针对HPV L1区基因序列进行PCR扩增,并通过DNA测序法对HPV进行基因分型。对于混合感染样品,利用HPV型别特异性引物PCR的方法进行基因分型。325例临床样品中,228例为HPV阳性,其中66例为混合感染。共发现27种不同的HPV型别,其中HPV 16比例最多,其次是HPV 58和52。高危型HPV检出率随病变程度加重显著性增加     

宫颈低级别鳞状上皮内病变组织CK8、P53及Ki-67的表达及其临床意义

摘要 目的：探讨宫颈低级别鳞状上皮内病变（LSIL）组织中细胞角蛋白 8（CK8）、P53及Ki-67的表达,分析其与病情进展的关系。方法：回顾性分析2020年1月至2021年12月我院收治的120例经病理确诊为LSIL患者的临床资料,根据末次随访病理学检查结果将其分为进展组（17例）、持续组（27例）和消退组（76例）。取首次活检宫颈组织标本,采用免疫组化法检测CK8、P53、Ki-67表达。多因素Logistic回归分析LSIL患者疾病进展的危险因素,受试者工作特征（ROC）曲线分析CK8、P53、Ki-67评估LSIL患者疾病进展的效能。结果：进展组宫颈组织中CK8、P53及Ki-67阳性表达率高于持续组和消退组（P＜0.05）,持续组宫颈组织中CK8、P53及Ki-67阳性表达率高于消退组（P＜0.05）。高危人乳头瘤病毒（HPV）感染、CK8阳性细胞占比（较高）、P53阳性细胞占比（较高）、Ki-67阳性细胞占比（较高）是LSIL患者疾病进展的危险因素（P＜0.05）。联合CK8、P53、Ki-67阳性细胞占比预测LSIL患者疾病进展的曲线下面积为0.846,高于单独指标预测的0.637、0.697、0.744。结论：LSIL进展宫颈组织中CK8、P53、Ki-67阳性表达率明显升高,CK8、P53、Ki-67阳性细胞占比升高增加了LSIL患者疾病进展的风险,可作为辅助评估 LSIL进展的生物学指标。     

环氧化酶-2和CD44v6蛋白在宫颈鳞癌中表达及临床意义

探讨环氧化酶-2(cyclooxy-genase-2,COX-2)和CD44v6蛋白在官颈上皮内瘤样病变(CIN)和浸润宫颈鳞癌(ICC)中的表达及其意义.应用免疫组织化学方法,检测45例ICC、25例CIN和10例正常宫颈组织(NCE)中COX-2和CD44v6蛋白的表达水平,并结合临床病理特征进行分析.结果表明,在ICC、CIN和NCE中,COX-2蛋白表达阳性率分别为82.2%(37/45)、40%(10/25)和0%(0/10),差异有显著性(P＜0.05);CD44v6蛋白表达阳性率分别为88.9%(40/45)、44%(11/25)和20%(2/10),差异有显著性(P＜0.05).COX-2和CD44v6蛋白表达与ICC的分化程度和淋巴结转移相关(P＜0.05),但与临床分期无关(P＞0.05).COX-2和CD44v6可能参与了调控ICC的发生、发展过程,其高表达预示ICC预后不良.     

Diagnostic and prognostic significance of image cytometric DNA ploidy measurement in cytological samples of cervical squamous intraepithelial lesions

D. Demirel, N. Akyürek and I. Ramzy
Diagnostic and prognostic significance of image cytometric DNA ploidy measurement in cytological samples of cervical squamous intraepithelial lesions Objective: To study the DNA ploidy pattern of uterine cervical squamous intraepithelial lesions (SILs) and its diagnostic and prognostic significance. Methods: The study included 31 cases of SIL: 11 low‐grade (LSIL) and 20 high‐grade (HSIL). Feulgen–pararosaniline staining was performed on previously Papanicolaou‐stained smears and a DNA image cytometric study was performed. An internal reference was used to calibrate the samples. Results: All 31 cases of SIL, either LSIL or HSIL, were non‐diploid. Of the 11 cases of LSIL, four were tetraploid and seven were aneuploid, whereas, of the 20 cases of HSIL, four were tetraploid and 16 were aneuploid. Stemline aneuploidy was not a significant discriminator between LSIL and HSIL (P = 0.32). Based on single‐cell analysis, HSIL cases had significantly higher DNA content than LSIL cases (P < 0.01). When a mean of 30% or more was used for the 6c‐exceeding event (6cEE) value, the sensitivity and specificity to indicate HSIL were 83% and 64%, respectively, with a positive predictive value (PPV) of 81% and negative predictive value (NPV) of 65%. All HSIL cases were cervical intraepithelial neoplasia grade 2 or worse (CIN2+) on biopsy. In addition, cases which showed recurrence had more DNA content by single‐cell analysis than those with an indolent clinical behaviour: P = 0.04 and P = 0.03 for LSIL and HSIL, respectively. Conclusions: Image cytometric DNA analysis is a useful technique for diagnostic and prognostic purposes in uterine cervical SIL when appropriate ‘c’ values are used in single‐cell analysis. We propose that a >6c DNA content of 30% is useful as a cut‐off level for predicting cases with CIN2+ in DNA image cytometry of cervical smears.     

Detection of Bacteroides fragilis in clinical specimens by polymerase chain reaction amplification of the neuraminidase gene

The polymerase chain reaction (PCR) was used in an attempt to detect Bacteroides fragilis by amplifying a segment of the gene encoding B. fragilis neuraminidase. Forty-five reference strains representing 45 species and 113 clinical isolates were tested. Only B. fragilis was PCR positive, except for Bacteroides merdae ATCC 43184, which gave a band by ethidium bromide staining that showed no signal by Southern hybridization. Using a protocol that employed DNA extraction by Sepa Gene kit and a highly sensitive digoxigenin-chemiluminescence detection system, detection of B. fragilis by PCR was in complete agreement with culture results for 44 clinical specimens from which a wide range of aerobic and anaerobic organisms and fungi were recovered.     

Genomic characterization of the human prion protein (PrP) gene locus

Prion protein (PrP) is intimately linked with a class of neurodegenerative diseases known as transmissible spongiform encephalopathies (TSEs). Employing bioinformatics and direct molecular analysis, we demonstrated that the human PrP gene (PRNP) locus, which is situated at Chromosome (Chr) position 20p12-ter, contains three genes within a 55-kb interval: PRNP; DOPPEL or PRND, located 20 kb 3? of PRNP; and a novel gene, designated PRNT, that maps 3 kb 3? to PRND and is transcribed to generate at least three alternatively spliced mRNAs. All three genes of this locus demonstrate low sequence homology, implying that, although they may be evolutionarily related, they are functionally distinct. Analysis of both adult and fetal human tissues confirmed the ubiquitous but variable expression profile of PRNP, with the highest levels observed in the CNS and testis. Contrastingly, although PRND shows a wide tissue expression pattern in fetal tissues, it is expressed exclusively in adult testis, whereas all three PRNT isoforms were detected only in adult testis, implying that PRND is developmentally regulated. An investigation of the regulatory mechanisms underlying this complex gene expression pattern from the PRNP locus should provide insight into the function of these genes and the possible involvement of the non-PrP proteins in the development of TSEs.     

人端粒酶催化亚基hTERT基因启动子的克隆

为了确定人端粒酶催化亚基 h TERT基因的启动子结构特征 ,采用 Panhandle PCR技术 ,从正常人外周血单核细胞基因组 DNA中扩增 h TERT基因 5′端上游旁侧序列 ,结果获得了 h TERT基因翻译起始位点上游 2 0 90 bp的基因组 DNA序列。序列分析表明 h TERT基因的启动子区域缺少典型真核启动子的核心元件 ( TATA box和 CAAT box) ,但含有多个已知转录因子蛋白结合的核心序列 ,如 E box及 Sp1核心序列。提示 h TERT基因的表达可能受特殊的转录因子调控 ,这些转录因子的激活可能与癌变细胞中 h TERT重新组成型表达有关     

Cytophotometric analysis of corresponding cytological and histological cervical intraepithelial neoplasia grade III specimens

Cytophotometric analysis of cervical intraepithelial neoplasia grade III (CIN III) was performed in 22 cytological smears (CS) and in 22 corresponding cytospin specimens retrieved from selected areas of paraffin-embedded tissues (PEC). The average time interval between cytological and histological diagnosis was 6 weeks. CIN III nuclei in CS and PEC specimen were Thionin-Feulgen stained and digitized. Beside the visual classification of DNA ploidy patterns, the 2.5c and 5c exceeding rates and the specimen mean and standard deviation values of 21 photometric features were also analyzed. It was shown that, although there was a significant correlation between DNA ploidy patterns in corresponding PEC and CS specimen, the DNA patterns were dissimilar in eight of 22 cases. The DNA index, as represented by 2.5c and 5c exceeding rates, was significantly higher in the CS specimen. High-resolution cytophotometric analysis of cell nuclei in CS and PEC specimens showed significant differences for a large number of nuclear photometric features. These findings can possibly be explained by differences in selection of CIN III cells from CS and PEC specimens and by differences between fixation procedures as used for the two techniques. It was concluded that cytophotometric data of CS and PEC specimens representing CIN III lesions should not be regarded as interchangeable.     

O-8Detection of human telomerase gene (TERC) amplification in cervical neoplasia: a retrospective study of 50 patients with normal smears or mild or moderate dyskaryosis

Circulation E of the North West non gynaecological cytology EQA scheme was split into two with one half receiving conventional glass slides and the other half receiving digital images supplied by the SlidePath company over the web. More of the participants eligible participated in the slide half (43/65) than the digital half (17/41).
Similar results were obtained for seven out of ten of the scoring cases and for both the educational cases. However for one case eight of the digital participants could not obtain the images over the web. In the remaining three scoring cases the digital participants were less good at obtaining the correct answer compared to the slide based participants. The use of this virtual microscopy has shortened the circulation length considerably. The digital participants complained about the speed the digital slides appeared on their computers and whilst most agreed that this is the way forward they are still uncomfortable with their performance being marked on their digital submissions. Delegates will have the opportunity of viewing still images taken for each case from this circulation.