支气管肺泡灌洗液淋巴细胞端粒酶活性检测对肺癌诊断意义

Detection of lymphocytes telomerase activity in bronchoalveolar lavage fluids for the diagnosis of lung cancer

目的通过检测支气管肺泡灌洗液(BALF)中的淋巴细胞的端粒酶活性(TA),探讨其对BALF端粒酶活性检测的影响,评价TA在肺癌中的诊断意义。方法将52例患者按最终临床诊断结果分为恶性(27例)、良性(25例)两组,用密度梯度离心法分离BALF标本获得淋巴细胞;应用TRAP-ELISA法检测淋巴细胞和同组对照标本的端粒酶活性,结果以OD值表示,计算该方法的敏感性、特异性、阳性预测值、阴性预测值、准确性等,结果用t检验和χ2检验。结果端粒酶活性检测(TA):25例良性肺病组中只有1例TA检测阳性(1/24),OD值为0.091±0.027,分离的18例淋巴细胞无1例阳性,OD值为0.064±0.013;27例肺癌中有24例阳性,OD值为0.630±0.350,分离的淋巴细胞有1例阳性,OD值为0.084±0.013,分离的肿瘤细胞全部阳性;TA检测的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为88.9%、95.8%、96%、88.5%、92.2%,经统计分析:恶性和良性两组间TA差异有显著性(P<0.01),淋巴细胞的TA对总体对照无明显影响(P>0.01)。结论BALF中淋巴细胞的端粒酶活性对TA检测结果无明显影响,TA检测可以作为肺癌的诊断方法。

Objective To determine the activity of telomerase in lymphocytes, which were separated from bronchoalveolar lavage fluids （BALF）, and to investigate its effect on the overall activity of exfoliated cells in BALF, which can be used to assess the diagnostic value of telomerase activity in lung cancer. Methods According to the final diagnosis achieved, 52 cases were divided into two groups ： malignant group （27 patients） and benign group （24 patients）. Lymphocytes were obtained from BALF by density gradient centrifugation assay, then TA were performed by TRAP-ELISA in lymphoeytes samples and control ones of the same group, respectively. In the end, the following data such as sensitivity, specificity, positive predictive value, negative predictive value and accuracy of telomerase activity were available. Differences of the results were evaluated by t test and chi-square test. Results TA assay ： in the malignant group, 24 of 27 samples were found to possess telomerase activity, while 1 of 25 samples in the benign one was positive with enzyme activity. The OD values were 0. 630 ±0. 350 and 0. 091 ±0. 027, respectively. In 52 pleural effusions, sensitivity, specificity, positive predictive value, negative predictive value and accuracy of TA test were 88.9%, 95. 8%, 96%, 88.5%, 92.2%, respectively. There was significant difference between the malignant and the benign groups （ P 〈 0.01 ） , while TA of lymphocytes had no effect on overall results （ P 〉 0. 01 ）. Conclusion TA of lymphocytes has no effect on overall results in BALF. Detection of telomerase activity of exfoliated cells in BALF may be used as diagnostic method in lung cancer.