胰管刷检细胞端粒酶活性检测诊断胰腺癌的临床意义

目的:探讨胰管刷检细胞端粒酶活性检测在胰腺癌诊断中的价值.方法:对27例胰腺疾病患者采用ERCP下胰管细胞刷获取标本,H-E染色,进行病理学观察;其中21例采用PCR-TRAP-ELISA法测端粒酶活性,并与常规细胞学及血清CEA、CA19-9检查作比较.结果:胰腺癌患者端粒酶活性水平明显高于慢性胰腺炎患者,以端粒酶活性D>0.2为阳性界限值,胰腺癌端粒酶活性阳性率为77.8％,慢性胰腺炎无1例端粒酶阳性,胰管刷检细胞端粒酶活性检测和细胞学诊断总符合率为77.8％,端粒酶活性与胰腺癌部位未见明显相关.结论:胰管刷检标本细胞学检查的同时结合端粒酶活性检测是提高胰腺癌诊断水平的有效方法.

Detection of telomerase activity in pancreatic duct brushing cells for diagnosis of pancreatic cancer

Objective:To investigate the diagnostic value of detecting telomerase activity in the exfoliated cells obtained from pancreatic duct brushing. Methods:In 27 patients with suspected malignancy, cytologic examinations of pancreatic duct brushing obtained during ERCP was performed. Telomerase activity was measured by the polymerase chain reaction and telomeric repeat amplification protocol assay(PCR TRAP ELISA) in 21 cases, the result was compared with the routine cytological diagnosis,CEA and CA19 9.Results:The positivity of telomerase activity in cell collected from pancreatic duct brushing was 77.8% in patients with pancreatic cancer(14/18),and none in patients with chronic pancreatitis when the cutoff value of telomerase activity was set at 0.2. The accordance of telomerase activity detection and cytological examination were 77.8%(14/18). Telomerase activity did not correlate with location of pancreatic cancer.Conclusion:The results suggest that cytologic examinations combined with the detection of telomerase activity in the exfoliated cells obtained from pancreatic duct brushing may be an effective and sensitive assay in diagnosis and differential diagnosis of pancreatic cancer.