目的 探讨表皮生长因子受体(epithelial growth factor receptor,EGFR)在子宫颈鳞状上皮内病变中基因扩增及临床意义.方法 在液基细胞学基础上应用荧光原位杂交(FISH)技术检测78例子宫颈各种病变组织[正常组28例、低度鳞状上皮内病变(LSIL)26例和高度鳞状上皮内病变(HSIL)24例]中的EGFR基因扩增情况.结果 EGFR基因扩增阳性率在正常组、LSILs和HSILs中分别是7.14%、23.08%和62.50%,HSILs的阳性率与LSILs及正常组相比均有差异.同时,LSILs随访阳性病例的EGFR基因扩增阳性率与随访阴性病例之间也有差异.另外,比较了部分病例中EGFR基因扩增与HPV的病毒负荷量.结论 EGFR基因扩增在HSILs与随访阳性LSILs中明显增高,提示EGFR基因扩增与子宫颈严重细胞学病变密切相关.因此,EGFR基因扩增可作为巴氏试验中筛查HSILs与预测持续或进展性LSILs的客观遗传学监测指标.%Puepose To investigate the gene amplification and clinical significance of the epithelial growth factor receptor( EGFR )gene in cervical lesions. Methods This study was designed to detect the EGFR gene amplification hy liquid-based cytology and fluorescence in situ hybridization ( FISH ) techniques in 78 cases of cervical various lesions [ 28 cases of normal control cervix, 26 low grade squamous intraepithelial lesion ( LSIL ) and 25 high grade squamous intraepithelial lesion ( HSIL ) ]. Results Positive gene amplification rates of the EGFR gene in normal cervix, LSIL and HSIL were 7. 14％ , 23. 08％ and 62. 50％ , respectively. There was a significantly difference between HSIL and normal control cervix or LSIL ( P ＜ 0. 01 ). At the same time, the gene amplication rate of EGFR was also significantly different between the cases of LSIL with positive follow-up and negative follow-up ( P ＜ 0. 01 ). In addition, the correlation between EGFR gene amplification and HPV viral load in the same sample was evaluated in some cases. Conclusions The increase of EGFR gene amplification in HSILs and LSIL with positive follow-up suggests that EGFR gene amplification is associated with the severity of cytologic findings. Therefore, detection of EGFR gene may provide an objective genetic test for the assessment of cells in Pap smears and serves as a screening marker for HSILs or LSILs, which may help determine the progressive potential of individual lesions.
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