乳腺不典型增生端粒酶活性检测在早期乳腺癌诊断中的价值

Value of detection of telomerase activity in atypical hyperlasia for diagnosis of early breast cancer

目的探讨细针穿刺乳腺不典型增生中端粒酶活性检测对早期乳腺癌的诊断价值。方法对临床有早期乳腺癌高危征象(乳腺局限性腺体增厚、乳头溢液、乳腺内小结节、乳房肿块、钼靶显示砂粒样钙化点)患者,术前行乳腺细针穿刺,分别行细胞学检查和端粒酶活性检测,并与术后病理检查结果相对照。结果在67例有早期乳腺癌高危征象患者中,术前细胞学检查阳性者7例,端粒酶阳性表达者24例;术后病理诊断乳腺不典型增生30例,其他乳腺良性病变30例,早期乳腺癌7例。乳腺上皮不典型增生中,端粒酶活性随增生程度加重而逐渐升高(P=0.004)。结论端粒酶在乳腺上皮不典型增生中即有表达,且随不典型增生程度加重其活性逐渐升高。早期乳腺癌高危患者术前细针穿刺检测端粒酶活性,对乳腺癌的早期诊断有较大的应用价值。

Objective To investigate the diagnostic value of detection of telomerase activity by fine needle aspiration in atypical hyperplasia of breast. Methods Patients who had high risk signs of early breast cancer（ localized thickening of mammary gland, discharge from nipple, intramammary nodule, breast masses, areatus calcified bodies in radiography with molybdenum target tube）were examined with fine needle aspiration, and the results of cytological examination and the telomerase activity were analyzed and compared with the postoperative results of pathological examination. Results Of the 67 patients who had high risk signs of early breast cancer,7 were are positive in cytological examination and 24 were are positive in telomerase activity ;7 were are early breast cancer in postoperative pathological examination, 30 were atypical hyperplasia and 30 were other benign lesions. In breast atypical hyperlasia, the telomerase activity were increasing with the degree of hyperplasia, with statistical difference （ P = 0. 004 ）. Conclusion Telomerase expression is found in breast atypical hyperplasia, and increases with the degree of atypical hyperplasia. Detection of telomerase activity by fine needle aspiration has the important applicable value in early breast cancer diagnosis.