细针穿刺肿瘤组织端粒酶活性检测在乳腺癌诊断中的意义

目的：探讨细针穿刺乳腺肿瘤组织端粒酶活性检测在乳腺癌诊断中的意义。方法：用PCR-ELISA法检测79例术前乳腺肿瘤穿刺活检标本和大体标本的端粒酶活性并与病理诊断进行对照。结果：乳腺癌65例，穿刺组织端粒酶阳性57例，阳性率为87．7％；大体组织端粒酶阳性54例，阳性率83．1％；淋巴结有转移者端粒酶活性高于无淋巴结转移者；乳腺良性疾病14例，端粒酶阳性2例，阳性率14．3％。结论：术前乳腺肿瘤穿刺组织端粒酶活性检测有利于乳腺肿瘤的早期诊断及鉴别诊断，可以间接了解乳腺癌的进展程度。     

乳腺癌细针穿刺标本中端粒酶活性的临床意义

目的　研究乳腺细针穿刺细胞标本中的端粒酶活性 ,探讨其在乳腺癌辅助诊断中的临床意义 ;研究端粒酶表达与PR、ER、PCNA、c erbB2及p5 3之间的可能关系。方法　采用PCR TRAP技术检测 99例乳腺细针穿刺标本中的端粒酶活性。采用免疫组化技术检测 35例乳腺癌组织标本中孕激素受体 (PR)、雌激素受体 (ER)、细胞增殖核抗原 (PCNA)、癌基因c erbB2及p5 3蛋白表达水平。结果　 83例乳腺癌标本 ,在 6 9例细胞学阳性标本中 6 1例端粒酶阳性 ,7例细胞学可疑标本中 5例端粒酶阳性 ,7例细胞学阴性标本中 4例端粒酶阳性 ,端粒酶敏感性为 84.3% (70 / 83) ,端粒酶活性检测和细胞学诊断总符合率为 77.1% (6 4/ 83) ;12例乳腺良性病变标本中 ,4例端粒酶阳性 ;4例乳腺炎标本均为阴性。端粒酶表达与乳腺癌组织学类型、淋巴结转移、肿瘤大小、临床分期无相关性 ,与PR、ER状态、PCNA、c erbB2 表达亦无相关性 ,但与p5 3蛋白表达水平呈负相关。结论　乳腺细针穿刺标本端粒酶活性检测在乳腺癌临床诊断中有辅助诊断价值 ;其与p5 3蛋白表达水平之间的关系有待进一步阐明。     

乳腺癌组织中端粒酶活性的研究

目的 :研究乳腺癌组织、癌旁组织、良性乳腺病变、正常乳腺组织中的端粒酶活性 ,探讨其作为乳腺癌肿瘤标志物的可能性。方法 :采用端粒重复序列扩增法 (telomeraicrepeatamplificationprotocol ,TRAP)来检测 36例乳腺癌及其相应癌旁组织 ,12例良性乳腺病变 ,6例正常乳腺组织中的端粒酶活性。结果 :36例乳腺癌组织中 ,有 33例端粒酶表达阳性 ,其阳性率为 91 7% ,而且与肿瘤的大小 ,淋巴结的状态 ,临床分期有相关性。 36例癌旁组织中 ,有 2例端粒酶表达阳性 ,阳性率为 5 6 %。 12例良性乳腺病变中 ,仅有 1例端粒酶表达阳性 ,阳性率为 8 3%。 6例正常乳腺组织端粒酶表达均为阴性。结论 :乳腺癌组织中普遍存在端粒酶活性表达 ,端粒酶有可能成为诊断乳腺癌的肿瘤标志物。     

乳腺癌组织中端粒酶活性的研究

目的细胞中端粒(telomere)的长度与细胞寿命的调控密切相关,端粒长度的维持需要端粒酶(telomerase)的激活,近年来的研究发现,端粒酶的激活与肿瘤的发生,发展关系密切.本文研究乳腺癌组织,癌旁组织,良性乳腺病变,正常乳腺组织中的端粒酶活性,探讨其作为乳腺癌肿瘤标志物的可能性.方法采用端粒重复序列扩增法(telomeraic repeat amplification protocol,TRAP)来检测36例乳腺癌及其相应癌旁组织,12例良性乳腺病变,6例正常乳腺组织中的端粒酶活性.结果 36例乳腺癌组织中,有33例端粒酶表达阳性,其阳性率为91.7%,而且与肿瘤的大小,淋巴结的状态,临床分期有相关性.36例癌旁组织中,有2例端粒酶表达阳性,阳性率为5.6%.12例良性乳腺病变中,仅有1例端粒酶表达阳性,阳性率为8.3%.6例正常乳腺组织端粒酶表达均为阴性.结论乳腺癌组织中普遍存在端粒酶活性表达,端粒酶有可能成为诊断乳腺癌的肿瘤标志物.     

乳腺癌组织中端粒酶活性的研究

目的：研究乳腺癌组织、癌旁组织、良性乳腺病变、正常乳腺组织中的端粒酶活性,探讨其人微言轻乳腺癌肿瘤标志物的可能性。方法：采用端粒重复序列扩增法（telomeraic repeat amplification protocol,TRAP)来检测３６例乳腺癌及其相应癌旁组织,１２例良性乳腺病变,６例正常乳腺组织中的端粒酶活性。结果：３６例乳腺癌组织中,有３３例端粒酶表达阳性,其阳性率为９１.7%,而且与肿瘤的大小,淋巴结构状态,临床分期有相关性,３６例癌旁组织中,有２例端粒酶表达阳性,阳性率为５.6%。１２例良性乳腺病变中,仅有１例端粒酶表达阳性,阳性率为８.3%。６例正常乳腺组织端粒酶表达均为阴性。结论：乳腺癌组织中普遍存在端粒酶活性表达,端粒酶有可能成为诊断乳腺癌的肿瘤标志物。     

原发性肺癌与食管癌组织中端粒酶活性表达的临床研究

目的 :探讨端粒酶作为一种新的生物学标志物用于常见胸部恶性肿瘤诊断和预后评价等方面的临床应用价值。方法 :采用端粒重复序列扩增法对原发性肺癌、食管癌手术切除组织及相应的癌旁组织进行端粒酶活性分析 ,并以相应的良性病变作为对照。结果 :3 2例肺癌组织中端粒酶阳性率为 84 4%( 2 7/3 2 ) ,癌旁组织为 9 4% ( 3 /3 2 ) ,良性组织中未检出端粒酶阳性。端粒酶活性随肺癌临床分期有升高趋势 ,伴淋巴结转移标本组阳性率 94 7% ( 18/19)明显高于非淋巴结转移组69 2 % ( 9/13 ) ,P <0 0 5 ;但与肿瘤病理组织学类型、分化程度等差异无统计学意义 ,P >0 0 5。 3 7例食管癌端粒酶阳性率为 86 5 % ( 3 2 /3 7) ,癌旁组织为 18 9% ( 7/3 7) ,正常食管组织未检出端粒酶阳性。当癌侵及肌层及外侵后 ,其阳性表达率 10 0 % ( 2 3 /2 3 )高于局限于黏膜及黏膜下层者 71 4% ( 10 /14 ) ,P <0 0 1。伴淋巴结转移标本阳性率 10 0 % ( 2 1/2 1)高于非淋巴结转移者 75 % ( 12 /16) ,P <0 0 5。结论 :端粒酶有可能成为肺癌、食管癌早期诊断和判断预后的重要生物标志物和治疗新靶点。     

乳腺不典型增生端粒酶活性检测在早期乳腺癌诊断中的价值

目的 探讨细针穿刺乳腺不典型增生中端粒酶活性检测对早期乳腺癌的诊断价值.方法 对临床有早期乳腺癌高危征象(乳腺局限性腺体增厚、乳头溢液、乳腺内小结节、乳房肿块、钼靶显示砂粒样钙化点)患者,术前行乳腺细针穿刺,分别行细胞学检查和端粒酶活性检测,并与术后病理检查结果相对照.结果 在67例有早期乳腺癌高危征象患者中,术前细胞学检查阳性者7例,端粒酶阳性表达者24例;术后病理诊断乳腺不典型增生30例,其他乳腺良性病变30例,早期乳腺癌7例.乳腺上皮不典型增生中,端粒酶活性随增生程度加重而逐渐升高(P=0.004).结论 端粒酶在乳腺上皮不典型增生中即有表达,且随不典型增生程度加重其活性逐渐升高.早期乳腺癌高危患者术前细针穿刺检测端粒酶活性,对乳腺癌的早期诊断有较大的应用价值.     

端粒酶活性在乳腺癌中的表达及临床意义

目的　研究乳腺癌中端粒酶活性的表达 ,探讨端粒酶活化与乳腺癌发生发展的关系及其作为乳腺癌肿瘤标志物的可能性。方法　应用TRAP 银染法及TRAP ELISA方法对 2 7例乳腺癌组织及 18例相应癌旁组织中的端粒酶活性进行了定性及定量测定。结果　在 2 7例乳腺癌组织中 ,发现有 2 3例端粒酶表达阳性 ,阳性率为 85 .2 % ;而 18例相应癌旁组织中只有 1例表达阳性 ;乳腺癌组织中的端粒酶活性 (A值 )为 0 .5 85± 0 .2 86;而相应癌旁组织则为 0 .0 95±0 .0 62 ,两者比较有显著性差异 (P <0 .0 1)。乳腺癌肿块直径≥ 2cm及淋巴结转移阳性者端粒酶活性水平显著高于 <2cm及淋巴结转移阴性者 (P <0 .0 5 ) ;而端粒酶活性与肿瘤的病理类型无明显相关性 (P >0 .0 5 )。结论　端粒酶活化在乳腺癌的发生发展中起重要作用 ,有可能成为乳腺癌早期诊断的理想肿瘤标志物。     

肺癌端粒酶活性表达临床意义的研究

目的　探讨端粒酶活性与肺癌发生发展的关系。方法　采用TRAP -银染法检测 42例外科手术切除的肺癌组织 ,35例癌旁正常组织 ,15例肺良性病变组织的端粒酶活性。结果　肺癌组织端粒酶活性的阳性率为 80 9% ,癌旁正常组织和肺良性病变组织端粒酶活性均为阴性 ;Ⅰ～Ⅱ期肺癌端粒酶活性的阳性率为 86 7% ,Ⅲ～Ⅳ期阳性率为 77 8% ;无淋巴结转移组肺癌端粒酶活性的阳性率为 92 3% ,有淋巴结转移组的阳性率为 75 %。结论　端粒酶活性表达与肺癌的临床分期、淋巴结转移无关 ;端粒酶可能是肺癌早期诊断的一个很好指标。     

乳腺癌患者外周血中端粒酶活性表达及其临床意义

目的：探讨端粒酶活性在乳腺癌患外周血癌细胞中的表达及其与浸润转移的关系。方法：通过用TRAP-PCR-ELISA法检测65例乳腺癌患外周血端粒酶的活性，按照肿瘤大小、分级程度、浸润情况、淋巴结有无转移来分析端粒酶与乳腺癌患生物学行为的相关性。结果：外周血中检测端粒酶活性阳性率为40．00％，低于相应的乳腺癌组织阳性率(61．54％)，乳腺癌患外周血中肿瘤细胞端粒酶相对活性的升高与患的淋巴结转移和浸润呈正相关。结论：检测患外周血中端粒酶活性可能优于检测肿瘤组织的端粒酶活性，可以对肿瘤患的病情进行实时监控，指导临床化疗。     

针吸细胞病理学在临床应用中的价值探讨

目的：探讨针吸细胞学在临床应用中的价值。方法：采用细针吸取细胞分析３６１９０人次诊断结果。结果：３６１９０人次针吸细胞学阳性检出率为８９．５％,７９１例细胞学诊断为肿瘤或瘤样增生者与病理对照,诊断符合率为８７．６％;２０６４例细胞学府晨瘤性疾病或病变者,被临床和病理证实为恶性肿瘤者２５例,生肿瘤１５６例,假队性率为８．８％。结论：针吸细胞学诊断的敏感性和特异性尚满意,具实用价值,但其准确性低于病理     

The detection of telomerase activity in patients with adenocarcinoma of the pancreas by fine needle aspiration

Telomerase activation in differentiated cells is associated with cell immortalization. Detection of telomerase expression in cancer provides a potential biomarker to be evaluated in the diagnosis and prognosis of cancer patients. Analysis of telomerase activity in biopsy specimens may serve as a useful marker for the diagnosis of pancreatic adenocarcinoma. This study was conducted to determine if telomerase could be detected in fine needle aspirates from patients with pancreatic carcinoma. The telomeric repeat amplification protocol (TRAP) assay was used to determine telomerase activity from pancreatic cancer cell lines, paired tumor/normal human pancreatic tissues and specimens obtained at the time of diagnostic fine-needle aspiration (FNA) biopsies. In this report, we demonstrate that: i) telomerase activity is present in pathologically confirmed pancreatic cancer specimens, but absent in matched adjacent areas of normal pancreatic tissues; ii) telomerase activity is present in FNA samples obtained at the time of CT-guided FNA of pancreatic adenocarcinomas; and iii) this activity can be detected in material normally discarded during FNA slide preparation. Activation of telomerase can be identified in FNA specimens obtained at the time of routine cytologic diagnosis. These findings may be useful for further diagnostic or therapeutic investigations of telomerase activity in pancreatic carcinoma.     

Ultrasound-guided core needle biopsy for breast cancer: preliminary report

BACKGROUND: Ultrasound-guided automated percutaneous core needle biopsy (US-CNB) for breast tumors has been introduced into clinical practice, but it has not yet been used routinely. We evaluated its usefulness, especially in terms of histological accuracy. METHODS: Thirty-one consecutive patients underwent mammography followed by breast biopsy with the automated core needle biopsy device. RESULTS: Mammography was highly suggestive of malignancy or suspicious abnormalities in 17 cases whose histological findings from US-CNB specimens were invasive ductal carcinoma without exception. The other 14 cases with benign or probably benign mammography findings showed no malignancy histologically in the US-CNB specimens. In cases of malignancy, the accuracy rates of histological findings for the specimens obtained by US-CNB were 94.1% in histological type, 100% in direct infiltration, 82.4% in lymphatic infiltration, 82.4% in venous infiltration, 94.1% in histological grading and 82.4% in intraductal spread. CONCLUSION: US-CNB was useful for making reliable preoperative histopathological diagnosis and may substitute fine needle aspiration biopsy and surgical biopsy.     

Preoperative discrimination of fibroadenoma which is clinically and cytologically indistinguishable from breast carcinoma through clonal analysis of fine needle aspirate of tumor: Report of a case

Recently, it has been demonstrated that breast carcimoma is monoclonal and fibroadenoma is polyclonal in origin. In the present case report, this observation was successfully applied to a preoperative differential diagnosis of a fibroadenoma clinically and cytologically indistinguishable from carcimoma. Case report: A45-year old female presented for clinical examination with a history of breast lump. A firm tumor measuring 2 x 2 cm was palpable in the upper-outer quadrant of @the left breast. The margin of the tumor was partially ill-defined and its mobility was restricted. A tumor shadow with a partially ill-defined margin was revealed by mammography. Ultrasonographic examination showed and irregularly-shaped, hypo-echoic tumor accompanied by an acoustic shadow. Fine needle aspiration biopsy yielded positive cytology. Based on these results, the tumor was diagnosed as breast carcinoma. However, clonal analysis of fine needle aspirates showed a polyclonal pattern, strongly indicating that the tumor was not a carcinoma but benign disease; most probably fibroadenoma. Thus, an open surgical biopsy was performed. Histoglogical examination revealed that the tumor was indeed a fibroadenoma with epithelial hyperplasia. This case suggests the usefulness of clonal analysis of fine needle aspirates in differentiating fibroadenoma from carcinoma of the breast.     

A case of mucinous carcinoma of the breast in which needle tract seeding was diagnosed by preoperative diagnostic imaging

Herein we report a 62-year-old woman with an excisable breast tumor in whom needle tract seeding was suspected during preoperative ultrasound and magnetic resonance imaging (MRI). A tumor of the right breast was observed during initial examination, and she was referred to our hospital after fine-needle aspiration cytology led to diagnosis of breast cancer, even though core needle biopsy results were negative. Mammography showed a high-density mass with a portion of the margin exhibiting very fine serrations. Ultrasonography revealed a circular mass with a border that was indistinct in some regions, and a hypoechoic band that extended from the tumor toward the skin. A mass was observed on MRI, with a linear enhancement extending on the skin side, and needle tract seeding was suspected. Fine-needle aspiration cytology revealed malignancy, and the histological appearance was consistent with mucinous carcinoma. T1cN0M0 stage I breast cancer was diagnosed, and wide excision and sentinel lymph node biopsy were performed. The skin directly above the tumor was concurrently excised to remove the biopsy puncture site. Histopathological diagnosis confirmed mucinous carcinoma, with the tumor observed to extend linearly into the subcutaneous adipose tissue in a pattern corresponding to the biopsy puncture site. The stump of the excised breast was negative for cancer cells. The possibility of tumor seeding must be considered during fine-needle aspiration cytology and biopsy. As demonstrated in this case, diagnosis of such seeding through preoperative imaging may enable extraction of the entire lesion, including the needle tract.     

针吸细胞学诊断恶性骨肿瘤93例分析

目的：为了探讨针吸细胞学在恶性骨肿瘤诊断中的价值。方法;对９３例Ｘ线片显示溶骨性破坏的病例,回顾性分析术前针吸细胞学与术后组织学诊断。结果;恶性肿瘤诊断符合率为８３．８７％,假阴性率１６．１３％,无假阳性。在诊断符合的７８例中,分型诊断符合率７５．６４％。：结论;针吸细胞学是一种简便,安全,快速诊断恶性骨肿瘤的重要方法。     

Estrogen receptor determination by monoclonal antibody in fine needle aspiration breast cancer cytologies: A marker of hormone response

A monoclonal antibody (H222) prepared against purified estrogen receptor has been demonstrated to be highly specific and sensitive in an immunohistochemical assay for the detection and quantification of estrogen receptor in human breast carcinoma biopsy specimens. To evaluate the clinical applicability of this assay in cytologic specimens, response to therapy in 12 patients with recurrent breast cancer was correlated with H222 antibody localization in specimens obtained by fine needle aspiration biopsy. All 7 patients with positive H222 responded to hormone therapy (1 complete and 3 partial remissions and 3 stable disease), while 1 of 5 patients with negative H222 responded (1 stable disease). This experience suggests a role for immunohistochemical estrogen receptor determinations in prediction of response to hormonal therapy in patients whose tumor is accessible only to aspiration biopsy. Special care in the handling and interpretation of specimens is essential to optimal application of this method.     

48. The value of CT scan and detection of telomerase activity in biopsy specimens for early diagnosis of lung carcinoma

Objective: To evaluate the diagnostic value of telomerase activity in the specimens of biopsy with bronchoscopy or cutting needle. Methods: Telomerase activity was measured in the biopsy apecimens taken from 52 patients suspected of having early lung cancer by CT scan. The PCR based silver staining telomeric repeat amplification protocol (TRAP) was used for detection of telomerase activity in 22 patients with early lung cancer (T1N0M0). Control study was made on the specimens taken from 24 patients with benign disease (cyst 3, TB 6, pseudtumor 5, pneumonjia 10). Results: The positive rates of telomerase activity were 86.45% (19/22) and 4.2% (1/24) in early lung cancers and benign lesions respectively (P<0.01). It was significantly higher in early lung cancers than in benign disease. All cases were diagnosed with surgical pathology and following for 2 years. Conclusion: Detecting telomerase activity in preoperative bronchoscope and cutting needle biopsy specimens may contribute to diagnosis of early lung cancer.     

Telomerase activity in human breast cancer and benign breast lesions: Diagnostic applications in clinical specimens,including fine needle aspirates

We analysed telomerase activity in normal, benign and malignant breast tissues and in fine needle aspirates by a PCR-based assay. The tissue samples we used in this assay consisted of 20 cryostat sections, 10 μm thick, from each breast biopsy. This method was used to obtain effective extraction from small samples and to confirm the histological identity of the specimen by microscopical examination of serial sections. Fifty-two of 71 breast carcinomas were positive for telomerase activity, and the intensity of this was strong in most cases, whereas all 6 samples of normal breast tissue and 17 of fibrocystic disease were negative and only 1 of 15 fibroadenomas was positive. Invasive ductal carcinomas were more frequently positive than invasive lobular carcinomas. There was no correlation of telomerase activity with tumour size or the occurrence of lymph node metastasis. Evaluation of our assay system showed that a signal of telomerase activity was detectable in extracts from single cryostat sections (> 1 mm²) of a cancer specimen and from as few as 4 cells of a human breast cancer cell line. On the basis of the above data, we applied this assay to fine needle aspirates of breast lesions. Ten of 15 aspirates which had been cytopathologically diagnosed as cancer were strongly positive, while 26 of 29 benign aspirates were totally negative and the remaining 3 showed only borderline activity. In 3 cases, the telomerase result could have helped establish a diagnosis when the cytological observations were inconclusive. Our results indicate that this sensitive assay could become a useful new modality for supplementing microscopic cytopathology in the detection of cancer cells in small tissue biopsies and fine needle aspirates. © 1996 Wiley-Liss, Inc.