检测端粒酶及其亚基在肺癌诊断中的临床价值

Study on the clinic value of detecting telomerase and its subunits for diagnosis of human lung cancer

目的探讨检测端粒酶活性及端粒酶亚基在肺癌临床诊断中的价值。方法随机收集肺癌和肺良性病变的肺手术切除标本，用作者建立的PCR—TRAP法检测端粒酶活胜，用免疫组织化学的方法检测端粒酶的两种蛋白质亚基-端粒酶逆转录酶（human telomorase reverse transcriptase，hTERT）和端粒酶相关蛋白1（human telomorase associated protein 1，hTP1）的表达。计算上述检测指标对肺癌，临床诊断的灵敏度、特异度和约登指数。结果肺组织端粒酶恬性及hTERT蛋白表达在肺癌组织、肺良性病变和正常肺组织之间差异有高度显著性（P〈0．001），hTP1表达在不同肺组织间差异无显著性（P=0．20）；端粒酶恬性、hTERT和hTP1对肺癌诊断的灵敏度分别为83．3％、90．0％和90．3％；特异度分别为95．0％、88．8％和5．0％；综合评价指标约登指数分别为0．78、0．79和0．04。上述检测指标与肺癌的不同组织娄型、分化程度及TNM分期等，临床特征无显著性关联。结论端粒酶活性和端粒酶催化亚基（hTERT）对肺癌的，临床诊断有一定价值，但对病情轻重和恶性程度的预测无显著意义。

Objective To explore the value of telomerase activity for lung cancer diagnosis. Methods The cancerous or noncancerous lung tissues were collected from patients with lung cancer or benign lung disorders. Telomerase activity was measured by PCR-TRAP method. The expression of the subunits of telomerase, human telomerase reverse transcriptase （hTERT） and human telomerase associated protein 1 （hTP1） were detected with immunohistochemical stain. The sensitivity, specificity, and Youden＇s index were calculated for the using of these biomarkers to the diagnosis of lung cancer. Results The defference of telomerase activity and expression of hTERT were highly significant among lung cancer, benign lesion and normal lung tissues, P〈0. 001 for both tests. Howerver, there was no significant difference for the expression of hTP1, P=0.20. The sensitivity for telomerase, hTERT and Htp1 were 83.3%,90.0% and 90.3%, respectively. The specificity were 95.0%, 88.8% and 5.0%, respectively, and the value of Youden＇s index were 0.78, 0. 79 and 0.04, respectively. These biomarkers were not associated with types, differentiation or TNM stages of lung cancers. Conclusion Detections of telomerase activity and hTERT were of significance in the diagnosis of lung cancer, but not for predicting the stage or malgnancy in lung cancers.