良恶性胸水细胞端粒酶活性的研究

目的：探讨端粒酶活性检测在良恶性胸水中的诊断价值。方法：采用TRAP－PCR－ELISA定量及TRAP－PCR银染定性法，对32例恶性胸水和29例良性胸水样本进行端粒酶活性分析，并将结果与胸水细胞学诊断结果进行比较。结果：端粒酶定性和定量结果均显示癌性胸水样本中端粒酶活性水平显高于良性胸水样本（P＜0．05）。端粒酶鉴别良恶性胸水的敏感性为71．8％（23／32），特异性为89．7％（3／29）；细菌学检查的敏感性为68．8％（22／32），特异性为100％（0／29）；两无显性差异（P＜0．05）。在22例细胞学阳性胸水样本有19例端粒酶阳性，2例细胞学可疑胸水标本1例端粒酶阳性，10例细胞学阴性胸水样本有3例端粒酶阳性。端粒酶检测和细胞学检查的符合率为82．6％，若2联合应用，胸水诊断的敏感性可提至84．4％。结论：端粒酶活性检测，可能在良恶性胸水的鉴别诊断方面，有重要的辅助诊断价值。

Detection of telomerase activity of pleural effusion cells in patients with malignant neoplasms and benign diseases

Objective To study the telomerase activity of pleural effusion cells in patients with malignant neoplasms and benign diseases. Methods The techniques of TRAP PCR ELISA and TRAP silver staining were employed to detect telomerase activity in 32 cases with malignant pleural effusion and 29 cases with benign pleural effusion. The results were compared with that of cytological examination. Results Telomerase activity in the samples of malignant pleural effusion were significantly higher than the cells of benign pleural effusion ( P <0.05).The sensitivity rate of telomerase activity in diagnosis of pleural effusion was 71.8%(23/32), and specificity rate was 89.7%(3/29),while the two rates of cytological examination were 68.8%(22/32) and 100% (0/29). There was no difference between them ( P <0.05). Telomerse activity was detected in 19 of 22 cytologic positive,1 of 2 cytologic suspicious and 3 of 10 cytologic negative specimens from patients with malignant pleural effusion. The coincidence rate of the detection of telomerase activity and cytological examination was 82.6%. The sensitivity rate of cytological examination combination with telomerase activity in diagnosis of pleural effusion would reach 84.4%.Conclusion The results suggest that measuring telomerase activity of pleural effusion cells would be helpful in diagnosis of patients with malignant neoplasms and benign disease.