原发性肝癌及慢性肝脏病变端粒酶活性的研究

目的比较原发性肝细胞癌（ＨＣＣ）及其癌旁不同慢性病变组织端粒酶活性的异同,探讨端粒酶活性在恶性肿瘤诊断中的意义。方法用ＴＲＡＰ方法检测３８例ＨＣＣ及其癌旁不同慢性病变肝组织的端粒酶活性。同时以４例正常肝组织为对照。结果３８例ＨＣＣ中３２例显示端粒酶活性（８６８％）。端粒酶活性与ＨＣＣ的细胞分化、类型、大小及有无乙型肝炎病毒（ＨＢＶ）感染无关,但与病人血清中甲胎蛋白（ＡＦＰ）水平相关。端粒酶活性阴性组ＡＦＰ水平明显低于各阳性组（Ｐ＜００１）。正常肝（４例）、先天性胆管闭锁（４例）、肝小叶间纤维增生（２例）、慢性病毒性肝炎（２例）及未见明显病变肝组织（７例）均未见有端粒酶活性。２５例肝硬化中４例端粒酶呈弱活性。结论端粒酶活性见于大多数ＨＣＣ及个别肝硬化组织,其活性可能在ＨＣＣ的发生、发展中起重要作用,有希望成为恶性肿瘤诊断的标记物。

Study on telomerase activity in hepatocellular carcinoma and chronic hepatitic disease

OBJECTIVE: To compare telomerase activity of hepatocellular carcinoma (HCC) with that of chronic liver disease to analyze the significance of telomerase activity in diagnosis of malignancy. METHODS: Telomerase activity was detected in 38 cases of HCC and corresponding non-tumor liver tissue with different chronic disease. That is 21 cases of hepatic cirrhosis, 2 cases of mild fibrosis, 2 cases of chronic viral hepatitis and 7 cases of non-tumor liver with no significant histopathological changes using TRAP assay. 4 cases of biliary atresia were also detected and 4 cases of normal liver tissue were the control. RESULTS: Telomerase activity was detected in 32 of 38 (86.8%) cases of HCC. Telomerase activity in HCC was not related with tumor cell differentiation types, tumor size and HBV infection, but expression of telomerase was highly correlated with serum alpha-fetal protein (AFP) level of patients. Telomerase negative HCC group has statistically significant lower level of AFP (P < 0.01) when compared with telomerase positive HCC groups. Telomerase activity was not present in normal liver tissue (0/4), biliary atresia (0/4), mild fibrosis (0/2), chronic viral hepatitis (0/4) and no significant changes of non-tumor liver tissue (0/7). Weak telomerase activity was detected in 4 of 21 hepatic cirrhosis. CONCLUSION: Telomerase activity was only detected in most of HCC and few cases of hepatic cirrhosis, which may play a crucial role in hepatocarcinogenesis and may be useful for the diagnosis of malignancy.