乳腺肿瘤组织中端粒酶的表达及其对诊治的意义

背景与目的：研究表明,端粒酶的活化可使细胞转化为癌细胞。本研究拟分析端粒酶在乳腺良性和恶性组织中的表达及其对乳腺癌早期诊断的价值。方法：应用PCR－ELISA方法检测178例乳腺癌、乳腺纤维瘤等患者术后组织中端粒酶的表达。结果：端粒酶阳性表达率在原发性乳腺癌组织为86．72％（111／128）;乳腺癌癌前病变组织为46．67％（7／15）;乳腺纤维瘤组织为26．66％（4／15）;乳腺非癌组织、囊性增生组织全阴性。乳腺癌在不同的临床分期中,端粒酶阳性表达率为临床I期63．16％,Ⅱ期85．96％,Ⅲ期为965％,Ⅳ期为100％。原发性乳腺癌伴腋窝淋巴结阳性者端粒酶阳性表达率为95．83％（69／72）,腋窝淋巴结阴性者端粒酶阳性表达率75％（42／56）。结论：端粒酶的表达与乳腺癌的临床分期（P＜0．005）,腋淋巴结转移密切相关（P＜0．01）。特别是它在乳腺癌癌前病变中有表达。端粒酶的检测对乳腺癌的早期诊断具有重要价值。

Significance of telomerase expression in diagnosis and treatment of breast tumor

BACKGROUND AND OBJECTIVE: It was reported that the activation of telomerase can turn normal cell into tumor cell. This study was designed to investigate the expression of telomerase in breast tumor and its value for early diagnosis and treatment. METHODS: Telomerase expression in 178 breast tumor specimens was detected by using PCR-ELISA immunohistochemical method. RESULTS: Positive expression rate of telomerase in primary breast carcinoma, precancerous lesion of breast, breast fiber tumor were 86.72% (111/128), 46.67% (7/15), and 26.66% (4/15), respectively. Negative expression of telomerase was shown in normal breast tissue and cystic hyperplasia tissue. Positive expression rate of telomerase in different clinical stage were 63.16% in stage I, 85.96% in stage II, 95.65% in stage III, 100% in stage IV, respectively. Positive expression rate of telomerase in the patients with and without positive axillary lymph node were 95.83% (69/72) and 75(42/56), respectively. CONCLUSION: Expression of telomerase was closely associated with clinical stages of breast cancer (P < 0.005) and metastases of axillary lymph node (P < 0.01). Special importance is that its expression was found in breast precancerous lesion, indicating its is significance in early diagnosis of breast cancer.