人喉鳞状细胞癌端粒酶活性检测的临床意义

目的： 了解端粒酶的激活是否人喉鳞状细胞癌发生、发展中的必需因素； 探索端粒酶活性可否作为喉癌细胞存在的肿瘤学标志。方法： 采用端粒酶重复扩增聚合酶链反应技术检测喉鳞状细胞癌、癌旁组织、喉乳头状瘤、声带息肉及正常声带粘膜的端粒酶活性。并对３例全喉切除患者的癌组织及其周边组织粘膜的端粒酶活性进行了拓扑学分析。结果： ３０ 例（９０－９ ％ ） 喉鳞状细胞癌、１０ 例（６６－６ ％ ） 癌旁组织及２ 例（１００ ％ ） 喉乳头状瘤端粒酶活性呈阳性结果； 而４ 例声带息肉和５ 例正常声带粘膜全部呈阴性。拓扑学分析表明不仅喉癌组织而且癌周边粘膜如手术切缘、声带、会厌等亦有酶活性检出。结论： 人喉鳞状细胞癌端粒酶活性阳性率高， 该酶的激活可能是喉癌发生的早期事件； 端粒酶活性的检测可能作为鉴别诊断喉癌与良性瘤的有用标志。

TELOMERASEACTIVITYIN HUMANLARYNGEALSQUAMOUSCELL CARCINOMAANDITSCLINICALSIGNIFICANCE

To investigate telomerase activation for development of human laryngeal squamous cell carcinoma and telomerase activity as a markerto detectthe existance ofim mortalla ryngealcarcinoma cellsin clinical materials . Methods: The telomerase activity ofspecimens of hu man laryngealsquamous cell carcinoma ,laryngeal papilloma , vacol cord polypi, tumor surround ing mucosa and normal mucosa of vacolcord were examined by using telomeric repeat amplification protocol PCR. In addition ,thetopographicalanalysis oftelomerase activity in specimenslaryngeal carcinoma and tumor surrounding mucosa of three patients from total laryngectomy were per formed . Results: Telomerase activity in 30 of 33 (90-9 % ) laryngeal squamous cell carcinoma , 10 of15 (66-6 % ) adjacenttissues, 2 of 2 laryngealpapillomas were detected , whereas0 of4 vo cal cord polypusand 0 of 5 normal mucosa had detectabletelomerase activity . Topographicalanaly sis demonstrated telomerase activity in the specimens of tumor, tumor surrounding mucosa , such as which from operation margins oftumor, vocalcord and epiglottic mucosa etc . Conclusion : Ac tivation oftelomerase was frequent in human laryngeal carcinomas and may occur early in the tu morigenesis process. Telomerase expression might contribute to the progression oflaryngeal squa mous cellcarcinoma and telomerase activity may be a useful markerfor distinguishinglaryngealcar cinoma from normaland benign laryngealtissues .