端粒酶催化亚单位在细胞学诊断肺癌中的表达

The expression of human telomerase reverse transcriptase in cytological diagnosis of lung cancer

目的:检测支气管镜涂片中端粒酶催化亚单位(hTERT)的表达,探讨其与肺癌发生的关系,探索细胞学诊断肺癌的新途径。方法:应用免疫组化和原位杂交的方法检测137例支气管镜涂片中hTERT和hTERTmRNA的表达,并与临床病理资料及细胞学诊断进行相关性分析研究。结果:137例病例中,hTERT和hTERTmRNA表达阳性率在细胞学诊断为癌细胞组分别为67.86%(57/84)和79.76%(67/84);疑癌或异型细胞组分别为46.67%(7/15)和60.00%(9/15);未见癌细胞组分别为5.26%(2/38)和39.47%(15/38)。二者的表达在癌细胞组明显高于其他2组(P<0.05)。其中有组织学对照的105例,hTERT和hTERTmRNA阳性表达率与细胞学诊断阳性率相一致。hTERT和hTERTmRNA的阳性表达率呈正相关性(r=0.994,P<0.05),但这二者的表达率与组织病理类型及其他临床特征差异均无显著性(P>0.05)。结论:端粒酶在支气管涂片中的阳性表达与肺癌的发生密切相关。hTERT和hTERTmRNA在癌组织中均存在高表达,且比传统形态学诊断更敏感。而hTERT蛋白的表达在细胞学涂片中更可靠(假阳性率低)。因此检测这二者的表达有助于提高肺癌的细胞学检出率,对早期发现、诊断肺癌有重要意义。

Objective： To detect the expression of hTERT protein and mRNA in bronchoscopic brushoff smears, elucidate the relations between it and lung cancer, and to explore a new way in cytological diagnosis. Methods： The expression of hTERT and hTERT mRNA of 137 cases of bronchoscopic brush-off smears were detected by immunohistochemistry staining and in situ hybridization. The correlation was analyzed statistically between the expression of hTERT and hTERT mRNA and clinic pathological parameters and cytological diagnosis. Results： The positive rate of hTERT protein expression and mRNA expression in malignant specimens were 67.86% （57/84）and 79.76% （67/84）; in the suspicious or dysphasic specimens were 46.67% （7/15）and 60.00% （9/15）;and in negative specimens were 5.26% （2/ 38）and 39.47% （15/38）o The positive rate in malignant specimens was significantly higher than that in other two specimens （P〈0.05）. There was no difference of the positive rate of hTERT protein expression and mRNA expression between 105 cases of histology compare and cytological diagnosis. And there was correlation between the expression of hTERT and hTERT mRNA （r=0.994, P〈0.05 ）. No significant difference was established between the expression and clinic pathological parameters （P 〉0.05）. Conclusion： There is correlation between hTERT positive expression in bronchoscopic brush-off smears and lung cancer, hTERT and hTERT mRNA is higher expression in cancer tissues, and is more sensitive than morphology diagnosis. The expression of hTERT protein is more reliable in cytological diagnosis in lung cancer （lower false positive）. To detect the expression of human telomerase reverse transcriptase（hTERT） protein and mRNA in lung cancer may increase the positive in cytological diagnosis, and there issignificance in the discovering and diagnosis lung cancer earlier.