尿端粒酶检测在膀胱癌诊断及术后监测中的意义

目的探讨尿端粒酶活性检测在膀胱癌早期诊断及术后复发监测中的意义.方法采用PCR银染法于术前检测85例表浅膀胱癌患者尿液中脱落细胞端粒酶活性,并在行膀胱部分切除或经尿道膀胱肿瘤电切术(TURBt)后3个月和6个月时再检测尿端粒酶活性,同时行膀胱镜检查.结果术前85例表浅膀胱癌患者尿脱落细胞端粒酶活性阳性表达率为81.18%(69/85);术后67例获随访,6个月内尿端粒酶检测持续阳性者复发率为55.56%(20/36),持续阴性者复发率为19.23%(5/26),两组相比有显著性差异(P＜0.01);2例3个月为阴性而6个月转阳性者均复发,而3例3个月为阳性而6个月转阴性者均未复发.结论尿脱落细胞端粒酶活性检测可作为表浅膀胱癌早期诊断和术后复发监测的一种有效手段.

The significance of urine telomerase activity in the diagnosis and monitoring of post-operation recurrence of superficical bladder cancer

Objective To explore the relationship between telomorase activity in exfoliated urinary cells before and after transurethral resection of bladder tumor(TURBt) or partial cystectomy of superficial bladder cancer and early recurrence.Methods Urine samples were obtained from 85 patients with superficial bladder cancer prior to TURBt or partial cystectomy,they were followed up by cystoscopy at 3 and 6 months post operation in combination with urinary telomerase activity detection.Results Urinary telomerase activity pre operation was positive in 69 (81.18%) of the 85 patients.67 were followed up and within these patients,post operation recurrence rate of these with persistent positive urinary telomerase activity (20/36) was higher than those negative (5/26) within 6 months.These patients showed positive urinary telomerase activity by 3 month and negative by 6 month,none of them showed recurrence.Two patients recurred with negative telomerase activity 3 month and positive by 6 month.Conclusions The test of telemerase activity in urine exfoliated cells might be a useful tool in identification and mornitoring of the patients with superficial bladder cancer.It might serve as a predictor of post operational recurrence.