检测端粒酶活性在肺癌早期诊断中的价值

目的　探讨端粒酶作为肺癌肿瘤标记物的可能性 ,评价端粒酶活性对肺癌的早期诊断价值。方法　采用改良银染 -端粒重复序列扩增法 (TRAP)检测 40例原发性支气管肺癌手术标本及 40例CT扫描疑诊为肺癌患者的纤维支气管镜活检标本的端粒酶活性。结果　两组中小细胞肺癌端粒酶阳性率均为 10 0 % ,非小细胞肺癌分别为 84.8%、95 .7%。 40例手术切除肺癌组织的端粒酶阳性率为 87.5 % ( 3 5 /40 ) ,癌旁肺组织为7.5 % ( 3 /40 ) ,正常肺组织无表达 ( 0 /40 ) ,三组间比较有显著性差异 (P <0 .0 1)。 40例CT扫描疑诊为肺癌患者的纤维支气管镜肺活检标本的端粒酶阳性率为 82 .5 % ,肺癌检出的敏感度为 96.4% ,特异度为 71.4% ,准确性为 91.4% ;尤登指数 (Youden’sIndex)J =0 .678,SE(J) =0 .174。结论　端粒酶是灵敏的肺癌肿瘤标记物 ,对纤维支气管镜活检标本行端粒酶活性检测有助于肺癌的早期诊断。

The value of detecting telomerase activity on early diagnosis of lung cancer

Objective　To explore the possibility of telomerase as tumor marker of lung cancer and to evaluate its value on early diagnosis of lung cancer. Methods　Telomerase activity was measured in 40 resected specimens of lung cancer and 40 preoperative fibro-optic bronchoscope biopsied specimens of suspected lung cancer by PCR based silver staining telomeric repeat amplification protocal (TRAP) respectively. Results　The positive rate of telomerase was 100％ in SCLC, but 84.8％ in resected samples and 95.7％ in biopsied samples in NSCLC. The positive rate of telomerase was 87.5％(35／40) in resected lung cancer tissues, 7.5％(3／40) in paracancerous tissues and 0％(0／40) in normal lung tissues (P＜0.01). 82.5％ (34／40) biopsied specimens of suspected lung cancer were detected with telomerase activity. Its sensitivity, specificity, and accurate rate was 96.4％, 71.4％, and 91.4％ respectively for detection of lung cancer, Youden’s Index (J)＝0.678,and SE（J）＝0.174. Conclusion　Telomerase may be a sensitive tumor marker of lung cancer. Detecting telomerase activity in preoperative fibro-optic bronchoscope biopsied specimens may contribute to early diagnosis of lung cancer.