不同癌症患者血清胆固醇水平和组织的端粒酶活性分析及临床意义

Analysis and Clinical Significance of Cancer Patients' Serum Cholesterol Level and Telomerase Activity

目的分析研究癌症患者血清总胆固醇水平和组织的端粒酶活性及临床意义。方法对130例未经治疗的癌症患者、94例非癌症患者、100例健康体检者分别进行胆固醇水平测定,对77例低蛋白血症的癌症患者在纠正低蛋白治疗前后的总胆固醇进行对比分析;另采用聚合酶链反应-酶免法(PCR-ELISA)对130例同一批癌症患者检测不同癌症组织及相应癌旁组织和35例相应部位正常上皮组织中的端粒酶的活性。结果癌症组血清胆固醇水平明显低于非癌症组(P<0.01),非癌症组与健康组无明显差异(P>0.05);低蛋白癌症患者在蛋白纠正治疗后,胆固醇明显提高,接近正常人水平;各种癌组织端粒酶活性表达阳性率为:胃癌组织81.8%(9/11)、肝癌组织83.2%(10/12)、肺癌组织87.5%(21/24)、食道癌组织85.7%(6/7)、乳腺癌组织75%(6/8)、前列腺癌组织84.6%(11/13)等;不同部位的肿瘤组织端粒酶表达阳性率无明显差异(P>0.05)。相应肿瘤的癌旁组织端粒酶表达阳性率分别为:胃癌组织旁组织9.09%(1/11)、肝癌组织旁组织8.33%(1/12)、肺癌组织旁组织12.5%(3/24)、食道癌组织旁组织14.3%(1/7)、乳腺癌组织旁组织12.5%(1/8)、前列腺癌组织旁组织15.4%(2/13)等,与癌组织相比较,有显著性差异(P<0.01)。结论癌症患者在疾病发展过程中,癌细胞复制呈加速与失控状态,为了满足癌细胞合成细胞膜的需要,导致LDL代谢增加,使细胞大量从血液LDL颗粒内摄取胆固醇,致使血清胆固醇降低。癌症患者在纠正蛋白治疗后胆固醇水平明显提高,提示低胆固醇血症并非为内源性致癌因素。不同癌症患者组织中的端粒酶活性均呈高表达,而正常组织及相应癌旁组织不表达或表达阳性率极低。因此,血清胆固醇水平测定,可作为癌症诊断及预后观察的一项辅助指标;端粒酶的检测对恶性癌的诊断和癌前病变的早期发现、判断预后具有重要的临床意义。

Objective To research into serum cholesterol level and telomerase activity and their clinical significance in patients with cancer. Methods The cholesterol levels of 130 cases of untreated cancer patients,94 no cancer patients and 100 healthy subjects were examined respectively. The total cholesterol levels before and after the rectifications of low protein in 77 cases of cancer patients with hypoproteinemia were analyzed. In addition, to detect telomerase activity in same 130 cancer patients of different cancer tissues and tumor adjacent tissues and 35 cases of corresponding normal epithelial tissues by PCR - ELISA. Results The serum cholesterol level of carcinoma group was significantly lower than that in the no carcinoma group （ P 〈 0.01 ）. and there was no difference between the non carcinoma group and the healthy group（ P 〉 0.05 ）. After the rectification, the cholesterol level was increased significantly and approached that of healthy group. Positive rate of different cancer tissues＇ telomerase activity was：the stomach cancer tissues 81.8% （9/11） ,the liver cancer tissues 83.2% （10/12） ,the lung cancer tissues 87.5% （21/24） ,the esophagus carcinoma tissues 85.7% （6/7）, the breast cancer tissues 75% （6/8） , the prostate cancer tissues 84.6 % （ 11/13 ） and so on ; Positive rate of different tumor tissues telomerase activity was not obvious difference（ P 〉 0.05 ）. Positive rate of tumor adjacent tissues＇ telomerase activity was：the stomach cancer adjacent tissues 9.09% （ 1/11 ）, the liver cancer adjacent tissues 8.33% （1/12） , the lung cancer adjacent tissues 12.5% （3/24） , the esophagus carcinoma adjacent tissues 14.3 % （ 1/7 ） , the breast cancer adjacent tissues 12.5 % （ 1/8 ） , the prostate cancer adjacent tissues 15.4% （2/13） and so on. Comparing with cancer tissues, they have notable difference （ P 〈 0.01 ）. Conclusion During the pathogenesis of tumor, the reproductions Of tumor cells were accelerated and uncontrollable. In order to meet the need of synthesizing the tumor cell membrane, and simultaneously increases the LDL metabolism, the effect of which causes cells to ingest a great amount of cholesterol from blood LDL granule, the cholesterol content decreased. After the rectifications of protein, the cholesterol levels of cancer patients enhanced distinctly and prompted hypo- cholesteremia by no means for the endogenetic cancer factors. Positive rate of different cancer tissuestelomerase activity was high, but telomerase activity＇s positive rate of normal tissues and its tumor adjacent tissues were none or extremely low. Hence the cholesterol level is a useful criterion in assisting tumor diagnosis and monitoring prognosis. The examination of telomerase to the malignant cancer diagnosis and the finding of pathological change had the vital clinical significance.