甲状腺良恶性病变组织中端粒酶活性分析

Analysis of telomerase active in benign and malignant thyroid tissues

目的研究端粒酶在各种甲状腺肿瘤中的活性状态。方法用改良端粒重复序列扩增聚合酶链反应法(TRAP-PCR)在定性及定量水平上检验100例良恶性甲状腺组织标本及15例甲状腺癌细针穿刺标本的端粒酶活性。结果甲状腺癌组织的端粒酶阳性率(83·8%,31/37例),明显高于良性甲状腺病变(21·2%,7/33例)及病变旁正常甲状腺组织(10·0%,3/30例);15例甲状腺癌的细针穿刺标本也均呈阳性表达,与相应的组织标本相符。定量结果显示甲状腺癌组端粒酶活性明显高于良性病变及正常组织,髓样癌及间变癌的活性高于乳头状癌。结论端粒酶活性是恶性甲状腺肿瘤的一个敏感标志物。TRAP-PCR定量分析对甲状腺肿瘤的鉴别诊断具有重要意义。

Objective To study the status of telomerase activity during the development of thyroid tumors, and to determine whether telomerase activity can be used clinically as a molecular marker in the differential diagnosis of thyroid cancer. Methods Telomerase activity was measured in 37 thyroid carcinomas, 33 benign thyroid lesions and 30 normal thyroid tissue samples by means of telomerase repeat amplification procedure-polymerase chain reaction（TRAP-PCR）. The assay was also applied to 15 fine needle aspirates（FNAs） of thyroid carcinomas to test its sensitivity. Results Thirty-one of 37 thyroid carcinomas（83.8 % ）, 7 of 33 benign thyroid lesions（21.2 % ）, and 4 of 30 adjacent normal thyroid tissue asmples expressed telomerase activity, 15 FNAs also had positive telomerase activity ,just as their corresponding tissue specimens. The quantitative analysis showed that the telomerase activity was significantly higher in thyroid carcinomas than that in benign thyroid tissue samples. And medullary carcinomas and anaplastic carcinomas had higher levels of telomerase activity than papillary carcinomas. Conclusion Telomerase activity is a good marker for thyroid carcinomas. The quantitative TRAP-PCR might have more potential application in the differential diagnosis of tumors and the estimation of tumor progression and prognosis. And this sensitive assay could become a useful new modality for supplementing microscopic cytopathology in the detection of cancer cells in small tissue samples and FNAs.