不同类型肺癌标本端粒酶活性检测的临床意义

目的 :探讨不同类型肺癌标本端粒酶活性检测的临床意义 ,分析端粒酶活性与肺癌分期、组织学类型和有无淋巴结转移间的关系。方法 :收集 42例新鲜手术切除肺癌组织和 35例癌旁组织 ;6 3例肺癌支气管肺泡灌洗液 ,同时行刷片和灌洗液细胞学检查 ,31例非肺癌肺疾病的灌洗液 ;34例肺癌痰液 ,31例非肺癌肺疾病的痰液。采用PCR -TRAP银染法检测端粒酶活性。结果 :①新鲜手术切除肺癌标本和癌旁组织的端粒酶活性阳性率分别为 6 4.3% ( 2 7/ 42 ) ,0 % ( 0 / 35 ) ,( χ2 =34.6 1,P <0 .0 1) ;Ⅰ～Ⅱ期肺癌和Ⅲ～Ⅳ期肺癌端粒酶活性阳性率分别为86 .7% ( 13/ 15 )和 77.8% ( 2 1/ 2 7) ( χ2 =0 .0 9,P >0 .0 5 ) ;无淋巴结转移和有淋巴结转移的端粒酶活性阳性率分别为 75 .8% ( 2 2 / 2 9)和 92 .3% ( 12 / 13) ,( χ2 =0 .6 9,P >0 .0 5 )。鳞癌、腺癌、小细胞癌端粒酶活性阳性率分别为 77.2 % ( 13/ 18)、87.5 % ( 14 / 16 )和 87.5 % ( 7/ 8) ( χ2 =0 .13,0 .0 2 ,0 .0 3,P均 >0 .0 5 )。②肺癌与非肺癌肺疾病支气管肺泡灌洗液端粒酶活性阳性率分别为 76 .2 % ( 4 8/ 6 3)和 6 .5 % ( 2 / 31) ( χ2 =40 .6 ,P <0 .0 1)。端粒酶阳性率高于刷检( χ2 =0 .3.0 1,P >0 .0 5 ) ,高于灌洗液细胞学 ( χ2 =2 4.96

The study on clinic significance of detection of telomerase activity in specimens of different types of lung cancer

Objective: to access the clinic significance of detection of telomerase activity in specimens of different types of primary lung cancer, and to analysis correlation among telomerase activity and pathologic types, clinic stages and lymph node metastasis. Methods: having collected ①42 surgical specimens of lung cancer and 35 of normal lung tissue beyond 5 cm from lung cancer focus.②bronchoalveolar lavage fluid (BALF) of 63 lung cancer, at the same time the brush slide and lavage fluid cytology examination were carried out, and 31 other lung diseases.③sputums of 34 lung cancer and 31 other lung diseases. The telomerase activity was measured with the modified telomeric repeats amplification protocol (TRAP). Results: ①the positive rate of telomerase activity of surgical specimens and control group was 64.3%(27/42)and 0%(0/35)respectively (χ 2=34.96, P<0.01); the positive rate of telomerase activity ofⅠ-Ⅱ stage , 27 Ⅲ-Ⅳ stage, without lymphnode metastasis, with lymphnode metastasis, squamous cancer, adenocarcinomas and small-cell cancer respectively was 86.7%(13/15),77.8%(21/27) , 75.8%(22/29) , 92.3%(12/13), 77.2%(13/18)?87.5%(14/16) and 87.5%(7/8)(all P>0.05).②the positive rate of telomerase activity of BALF of lung cancer and other lung diseases was 76.2%(48/63)and 6.5%(2/31)respectively (χ 2=40.6, P<0.01), the positive rate of telomerase in BALF of lung cancer was higher than brush cytology(χ 2=3.61, P>0.05), and higher than BALF cytology (χ 2=24.96,P<0.01);③the positive rate of telomerase activity of sputum of lung cancer and other lung disease was 29.4%(10/34)and 3.2%(1/31)respectively (χ 2=7.9, P<0.01).Conclusion: Telomerase activity had been detected in different types of lung cancer including surgical specimens, bronchoalvealar lavage fluid and sputum. Telomerase activity had high sensitivity and specificity. Telomerase activity detection was available for diagnose of lung cancer. There was no significance for telomerase activity to predict cancer stage, lymph node metastasis and pathologic types.