肺癌纤维支气管镜刷检标本端粒酶活性检测

背景与目的:年来研究表明,端粒酶激活在肺瘤发生中起重要作用,但端粒酶活性水平检测用于肺癌小标本研究尚不多。本实验旨在探讨纤维支气管镜检查刷检标本端粒酶活性检测对肺癌诊断的价值。方法：应用TRAP－PCR－ELISA方法和TRAP－PCR－银染法检测66例纤维支 管镜刷检标本端粒酶活性,并分析其对诊断肺癌的价值。结果：56例肺癌纤支镜刷检标本端粒酶活性测定,阳性检出率为78．6％（44／56）,高于细胞学检查阳性率46．4％（26／56）（P＜0．005）,两者联合实验诊断肺癌敏感性93．7％。中央型肺癌纤支镜刷检标本端粒酶活性阳性率82．5％（33／40）,高于周围型68．8％（11／16）,但差异无显著性（P＞0．05）。定性法测定端粒酶活性阳性率与定量法相近,但发现定量法检测ΔA值较低的定性检测为弱阳性,条带较少,且条带不清晰。结论：端粒酶活性是肺癌诊断的分子生物学标志物之一。与细胞学检查相结合可提高肺癌的早期诊断率。

Detection of telomerase activity in bronchoscopic brush-off samples in patients with lung cancer

Background and Objective:Recent studies have shown that activ ation of telomerase plays an importa nt role in carcinogenesis.However,th ere was few report on the level of telo merase activity in small samples fro m the patients with lung cancer.This study was designed to investigate the diagnostic s ignificance of the detection of telo merase activity in bronchoscopic brush-off cells from the patients with lung cancer.Methods:Telomeric repeat amplification pro tocol(TRAP)-based telomerase polymerase chain reaction(PCR)-enzyme-linked immunosorbent assa y(ELISA)TRAP-PCR-silver staining were employed to detect telomerase a ctivity in 56samples of brushing cells from the patients with lung cancer and 10samples with inflammation.Results:The positive rate of telomerase acti vity in 56biopsy samples of lung cancer group was significantly higher than that in in flammation group(P<0.001).The sensitivity ,specificity,and accuracy of detection of telomerase activity was 87.5%,83.3%,and 86.3%,respectively.There wa s no significant difference in the positive rate of telomerase activity between centra l lung cancer and peripheral lung can cer.Positive rate of detection of te lomerase activity in bronchoscopic brush-off cells wa s 46.4%.The positive rate of telomerase activity detected in TRAP-PCR-E LISA was higher than that detected in TRAP-silver staining,but the significant difference was not found.It was found that samples with low absorbing value detected in the quantified way would show weak positive with less ladder bands or vagu e ladder bands if detected in the latter way.Conclusion:The telomerase activity may be a good marker for diag nosis of lung cancer.Combined with cytologic measure,it is possible to raise the early diagnostic rate of lung cancer.