晨尿脱落细胞端粒酶活性检测在膀胱癌中的诊断价值

目的：探讨检测晨尿脱落细胞端粒酶活性在膀胱肿瘤诊断中的作用，寻找一种敏感特异的非介入性方法诊断膀胱癌。方法：采用荧光定量聚合酶链反应试验（FQ-PCR）和细胞学方法，对39例膀胱移行细胞癌患者（肿瘤组）、20例膀胱良性疾病患者（对照组）晨尿脱落细胞进行了端粒酶活性检测，肿瘤组均行手术治疗，肿瘤标本作病理组织学检查，对两种方法检测的阳性率以及病理检查结果进行了分析比较。结果：FQ-PCR法检测肿瘤组患者晨尿脱落细胞端粒酶活性的阳性率为74．4％（29／39），显著高于尿细胞学检查的阳性率30．8％（12／39）；G1、G2、G3级膀胱移行细胞癌患者自排晨尿脱落细胞端粒酶活性阳性率分别为66．7％、77．3％和75％，无显著性差异。而对照组中仅1例表达有端粒酶活性，与肿瘤组比较有显著性差异（P〈0．005）。结论：FQ-PCR法检测晨尿脱落细胞端粒酶活性操作简便，特异、敏感，可以作为膀胱移行细胞癌早期诊断的无创性检查方法。

The Diagnostic Value of Telomerase Activity in Exfoliated Urothefial Cells Fo Rbladder Carcinoma

Objective:To explore the significance of detection of telomerase activity in exfoliated urothelial cells in the diagnosis of bladder carcinoma and seek a sensitive,specific noninvasive method for the diagnosis of bladder carcinoma.Methods:The techniques of FQ-PCR and cytological assay were applied to detect telomerase activity in 39 patients with transitional cellar cancer of bladder(neoplasm group)and 20 cases of benign bladder disease(control group).All patients in the neoplasm group underwent opertion and the bladder tumor specimens were histologically examined.Positive rate of detection between two methods and histological were comparatively studied.Results:Positive rate of telomerase activity detection using FQ-PCR assay in the neoplasm group was 74.4%(29 of 39),which was significantly higher than that of urinary cytological examination 30.8%(12 of 39).There was no significant difference in bladder transitional cancer group of Grade 1,2,3,their positive rates of telomerase activity detection in exfoliated urothelial cells were respectively 66.7%,77.3%and 75.0%,but only 1 case of telomerase activity in the control group.There was significant difference in the control group by compared with the neoplasm group(P<0.01).Conclusion:The procedure of detection of telomerase activity in exfoliated urothelial cells using FQ-PCR technique is simple,convenient,specific and sensitive,it would be a useful diagnostic marker for the early noninvasive identification of patients with bladder carcinoma.