人类鼻咽癌端粒酶活性的研究及其临床意义

目的　探讨端粒酶在鼻咽癌中的表达及其临床意义。方法　采用TRAP 银染法对 42例鼻咽部低分化鳞状细胞癌、10例鼻咽部正常粘膜和 8例鼻咽纤维血管瘤进行端粒酶活性检测及血清VCA/IgA检测 ,并分析其与临床病理的关系。结果　鼻咽部正常粘膜和鼻咽癌端粒酶阳性率分别为 2 0 %和 88.1% ,8例鼻咽纤维血管瘤均未检测到端粒酶活性。鼻咽癌伴颈部淋巴结转移者端粒酶阳性率高于无颈部淋巴结转移者 (P =0 .0 35 ) ,临床晚期 (III、IV)端粒酶阳性率高于临床早期 (I、II) (P=0 .0 48) ,而端粒酶与鼻咽癌患者的年龄、性别及远处转移均无明显相关性 (P >0 .0 5 )。鼻咽癌患者血清EB病毒VCA/IgA阳性率明显高于鼻咽粘膜正常者 (P <0 .0 0 1)。结论　端粒酶活性表达在鼻咽癌发病机制中起着重要作用。端粒酶活性结合血清EB病毒抗体的检测有利于鼻咽癌的早期诊断。

The study on the role of telomerase activity in human nasopharyngeal carcinoma

Objective To elucidate the role of telomerase activity in nasopharyngeal carcinoma (NPC).Methods Telomerase activity was detected using the telomere repeat amplification protocol(TRAP) combined with silver staining in 42 low-differentiated squamous carcinoma, 10 normal nasopharyngeal mucosae and 8 nasopharyngeal fibrohemangioma. Results Telomerase activity was detectable in 20% normal nasopharyngeal mucosae and 88.1% in NPC. The activity of telomerase was not detectable in 8 nasopharyngeal fibrohemangioma tissues. Telomerase activity was present more frequently in NPC biopsies with positive lymph node metastasis than in those without lymph node metastasis ( P =0.035). Furthermore, telomerase activity was observed more frequently in advanced NPC than in early stage ( P =0.048). However, there was no evidence to show the relationship between telomerase activity and other clinical features, such as age, gender and distant metastasis ( P >0.05). Serum EBV marker(VCA-IgA) was observed more frequently in NPC than in normal nasopharyngeal mucosae patients( P <0.001). Conclusion Telomerase activity may play a critical role in the tumorigenesis of NPC. Detection of telomerase activity combined with serological EBV markers may contribute to the screening and early diagnosis of NPC.