晨尿脱落细胞端粒酶活性的检测及临床意义

目的：评价尿脱落细胞端粒酶活性并探讨其临床意义。方法：采用改良的端粒重复序列扩增（TRAR）-银染方法检测了73例膀胱移行上皮细胞癌（transitional cell carcinoma,TCC）患（肿瘤组）、20例非恶性肿瘤泌尿系统其他疾病患（对照组）和21例正常人（正常组）的晨尿脱落细胞的端粒酶活性。同时做尿脱落细胞学检查。所有手术切除或活检的肿瘤标本作病理组织学检查。结果：肿瘤组尿脱落细胞端粒酶活性的阳性率为80.8%（59/73），明显高于尿脱落细胞学的20.5%(15/73）；对照组中有3例尿脱落细胞端粒酶阳性；正常组尿脱落细胞均无端粒酶活性。结合临床和病理资料分析发现T2～T4期端粒酶阳性率明显高于Tis～T1期。结论：尿脱落细胞端粒酶活性测定有望成为一种灵敏、特异的肿瘤标记物应用于临床。

Assaying telomerase activity of urine exfoliated cells and its clinical significance

Objective: To determine the value of telomerase activity in urine exfoliated cells as clinical indicator of tumor presence, stage, and recurrence. Methods: The techniques of TRAP-PCR and TRAP-sliver staining were employed to detect telomerase activity in 73 patients with TCC before operation (study group) and 20 benign urothelial cancer patients (control group) and 21 normal individuals (normal group). Cytologic results were obtained simultaneously. The bladder tumor specimens were obtained from 73 patients during operation, and histologically evaluated for tumor content and grade. Results: Positive rate of telomerase activity detection in TCC patients (80.8%,59 of 73) was significantly higher than that of cytological examination (20.5%, 15 of 73). Positive telomerase activity was not found in 17 of 20 in control group and none was found in normal group. Analysis of the distribution of abnormalities with tumor stage revealed greater detection of high pathological stage (T 2-T 4) (89.7%, 26 of 29) compared with low stage (Tis-T 1) (75%, 33 of 44). Conclusion: Detection of telomerase activity in urine exfoliated cells may be a sensitive and effective marker in the diagnosis of TCC.