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目的：探讨高危人乳头瘤病毒及人类染色体端粒酶基因(hTERC)在宫颈癌发生发展中的关系。方法：2010 年10 月至2011 年 05 月就诊于哈尔滨医科大学附属第一医院妇科患者445 例，采用表面等离子体谐振法（SPR）及荧光原位杂交法(FISH)分别检测高危HPV 和hTERC 的表达情况，对任一结果阳性者行阴道镜下宫颈活检和病理学检查，其中炎症对照组45 例，CIN 组33 例及宫颈癌组6 例。结果：单一型HPV29 例，多重型26 例，最常见为HPV16 型合并的二型感染（17 例）。在炎症组，CINⅠ组，CINⅡ 组、CINⅢ组及宫颈癌组中多重高危HPV 比率为17.78%、28.57%、44.44%、50.00%、66.67%，与炎症对照组比较其他组均有统计学意义（P<0.05）。hTERC 基因在各组中的阳性表达率分别为2.22%、14.29%、61.11%、75.00%及100%。CIN 组及宫颈癌的hTERC 基因表达与炎症组比较差异均有统计学意义(P 均<0.01)，其中CINⅡ及以上各组差异明显。多重HPV 感染与hTERC 表达呈中等正相关（r=0.462，P<0.01）。结论：随着宫颈病理类型分级升高，HPV 感染及hTERC 基因表达率升高，hTERC 基因在宫颈癌发生发展中起重要作用；高危HPV 感染与hTERC 基因的异常扩增关系密切，提示二者可能存在因果关系。

英文摘要:

Objective: To investigate the relationship of HR-HPV infection and the Human Telomerase Gene (hTERC) in the generation and progression of cervical cancer. Methods: The cervical samples of 445 women visited the First Clinical College of Harbin Medical University from October 2010 to May 2011 underwent the test for HR-HPV with SPR method. hTERC expression was detected by FISH. Then the sample with any positive result underwent colposcopic indicated biopsy and pathological diagnosis. Results: The pathological results showed that 45 of inflammation,33of CIN and 6 Cervical cancer. Among the 445 cases, there were 29 of single HR-HPV infection and 26 of multi-infection, including HPV 16/X double infection (17/26). The rate of multiple HR-HPV infection was 66.67% in cervical cancer group, 28.57% in CINⅠgroup, 44.44% in CINⅡgroup, 50.00% in CINⅢ group and 30.56% in inflammation group, respectively. The infection rate of any group was higher than that in inflammation group (all P<0.05). The positive amplification rate of hTERC in inflammation group was 2.22%, while it was 14.29% for CINⅠ, 61.11% for CINⅡ,75.00% for CINⅢand the cervical 100%for cancer, which showed a significant difference (all P<0.01), evidently in CINⅡand CINⅡ+. The multiple HR-HPV infection was middle-positive correlated to hTERC expression (r=0.462, P<0.01). Conclusions: As the development of cervical cancer, the HR-HPV Infection and hTERC expression increased and hTERC gene may play an important part in the pathogenesis of cervical cancer. The HR-HPV infection may be a positive-stimulated fact of hTERC gene.

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