胃癌及癌前组织中端粒酶活性的检测及其临床意义

目的探讨端粒酶在胃癌及癌前组织中的活性表达。方法采用端粒酶反复扩增法（ＴＲＡＰ）检测了１７６例不同病变胃粘膜组织端粒酶活性，其中慢性萎缩性胃炎（ＣＡＧ）５７例、肠上皮化生（ＩＭ）１８例、异型增生（Ｄｙｓ）８例及胃癌（ＧＣ）６５例（包括３例早期胃癌）。结果ＣＡＧ、ＩＭ、Ｄｙｓ及ＧＣ端粒酶阳性检出率分别为２４．６％、３８．５％、３７．５％及９２．３％，而正常组织（ＮＴ）未检出端粒酶活性，明显低于以上各组（Ｐ＜０．０１～０．０５）。癌组织端粒酶阳性率亦明显高于ＣＡＧ、ＩＭ及Ｄｙｓ组（Ｐ＜０．０１）；端粒酶阳性检出率与患者性别、肿瘤大小、浸润深度、大体类型、分化程度、有无淋巴结转移及临床分期无明显相关性。结论端粒酶不仅在胃癌组织中可以检测得到，而且在胃粘膜癌前病变或疾病中亦有表达。

Telomerase activity in gastric cancer and premalignant lesions: determination and its clinical significance

OBJECTIVE: To evaluate the role of telomerase activity in the development and progression of gastric cancer (GC) and if knowedge of telomerase activity may be an indicator for the early diagnosis and poteneial treatment of GC. METHODS: Using PCR-based TRAP (telomeric repeats amplification protocol) assay, we examined telomerase activity in 176 samples of gastric mucosa. Meanwhile, some tumor tissues were also analyzed by serial dilution. RESULTS: Telomerase activity detected in chronic atrophy gastritis (CAG), intestinal metaplasia (IM); dysplasia (Dys); and gastric cancer (GC) was 24.6% (14/57), 38.9% (7/18), 37.5% (3/8), and 92.3% (60/65) respectively; which was significantly higher than that in normal tissues (NT) (P < 0.01-0.05). Telomerase activity in group of GC was also significantly higher than that in group of CAG, IM and Dys (P < 0.01). Frequencye and levels of telomerase activity were not associated with patients' sex, tumor location, size gross type, depth of invasion, lymph node metastases, differentiation and clinical stage. CONCLUSION: Telomerase activity is detected not only in GC tissues, but also in some premalignant lesions or diseases.