肺癌端粒酶活性、p53、PCNA蛋白表达的联合检测及其临床意义

目的 探讨端粒酶活性p53基因和增殖细胞核抗原（PCNA）在肺癌发生发展中的作用，以及端粒酶与临床病理特点及p53,PCNA蛋白之间的关系。方法 TRAP法检测59例肺癌和35例癌旁正常组织中端粒酶活性，采用免疫组织化学法检测44例肺癌组织和35例癌旁正常组织中p53和增殖细胞核抗原（PCNA）蛋白的表达，并对端粒酶活性与临床病理特征以及p53PCNA蛋白表达的关系进行分析。结果 肺癌组织端粒酶活性,p53和PCNA蛋白阳性率分别为81．3％（48／59）、77．2％（34／44）、79．5％（35／44）；癌旁正常组织端粒酶活性,p53和PCNA蛋白阳性率分别为20．0％（7／35）、8．6％（3／35）、14．3（5／35），肺癌组织显著高于癌旁正常组织，P＜0．01，肺癌组织不同的病理类型之间、TNM各期之间以及不同的细胞分化程度之间端粒酶活性的阳性率未发现明显的差异（P＞0．05）；端粒酶活性与p53,PCNA蛋白表达之间无明显相关性。结论 端粒酶活化参与各型、各期和不同分化程度肺癌的发生发展；端粒酶在肺癌组织高表达和正常肺组织低表达的特性，有望使端粒酶成为肺癌诊断的1种标志物；p53和PCNA均参与肺癌的发生发展过程；端粒酶与p53和PCNA无明显相关性，提示肺癌是由多基因参与的疾病。

Detection of Telomerase Activity, p53, Proliferating Cell Nuclear Antigen in Lung Cancer and its Clinical Significance

Objective To study the role of telomerase activity,p53 and proliferating cell nuclear antigen(PCNA) in pathogenesis and progression of lung cancer and the relation among them.Methods Telomerase activity levels were measured in 59 lung cancer and 35 adjacent normal tissue by a modified telomeric repeat amplification protocol,and p53 mutations,PCNA protein were identified by immunohistochemical staining.Results were compared with clinical pathological feature.Results Telomerase activity was present in 48 of 59(81.3%) tumors and only 7(20.0%) of normal specimens( P <0.01).The p53 mutations and PCNA were present in 77.2% and 79.5%,of lung cancer respectively.No significant correlation between cell type,differentiation degree,staging,p53,PCNA,and telomerase activity levels was found.Conclusion Telomerase activation is a universal event in different TNM stage,type and differentiation;Telomerase presents high expression in lung cancer and low expression in normal lung tissue.It suggests that telomerase may be an useful diagnostic marker of lung cancer;There are no significant correlation between telomerase,p53,and PCNA.Multiple genes may be involved in the pathogenesis of lung cancer.