端粒酶活性在乳腺癌中的表达及临床病理学相关性研究

Correlative investigation of expression of telomerase activity and clinicopathologic parameters in breast cancer

目的 探讨端粒酶活性在乳腺癌的诊断价值及其临床病理学相关性。方法 应用端粒酶ＰＣＲ 酶联免疫吸附法定量检测４０ 例乳癌，３１ 例乳腺良性病变和９ 例正常乳腺组织端粒酶活性，同时与硝酸银染色定性检测对比。结果 端粒酶在乳癌、乳腺良性病变、正常乳腺组织表达的阳性率分别为７０ ％ （２８／４０） ，２９ ％ （９／３１） 和０ ％ （０／９） 。按定量检测其ＯＤ值分别为０．６０３，０．２５８ 和０．０３，３ 组之间均有显著性差异（ Ｐ ＜ ０ ．００１） 。端粒酶活性在乳癌中心和癌旁组织分别为０．６０３ 和０．２９３（ Ｐ ＜ ０ ．００１） 。按ＴＮＭ 分期，Ⅲ期（０．７８０ ±０．３９４） 高于Ⅱ期（０．５１１ ±０．４４７）（ Ｐ ＜ ０ ．０５） 。ＰＲ 阴性组（０．７８６ ±０．４４７） 高于ＰＲ 阳性组（０．５０１ ±０．３９３）（ Ｐ ＜ ０ ．０５） 。结论 良、恶性乳腺肿瘤端粒酶活性有显著性差异，可作为乳癌诊断的辅助指标之一；端粒酶活性与临床分期和ＰＲ 受体相关，提示端粒酶可作为反映乳癌侵袭性和预后的指标。

Objective To explore the diagnostic value and correlation of clinicopathologic parameters of telomerase activity in breast cancer. Methods The telomerase activity was detected through PCR ELISA comparation based on TRAP (telomeric repeat amplification protocol) assay in 40 cases of primary breast cancers, 31 benign breast lesions and 9 normal breast tissues. Simultaneously, a silver nitrate staining method was used as comparation. Results In primary breast cancers, benign breast lesions and normal breast tissues, the expression rate of telomerase was 70.0%(28/40), 29.0%(9/31) and 0(0/9) respectively; the optic density(OD) of telomerase activity was 0.603, 0.258 and 0.03 respectively (P<0.001). The telomerase activity in center of breast cancer and para carcinoma tissue of breast tissue was 0.603 and 0.293 respectively (P<0.001). Telomerase activity in stage Ⅲ (0.780±0.394) and in PR negative group (0.786±0.447) were higher than that in stage Ⅱ (0.511±0.447) and in PR positive group (0.501±0.393) (P<0.05). Conclusions Telomerasea activity has significant difference between the malignancy and benign tumors of breast, so it may be used as an assistant index for the diagnosis of breast cancer. As telomerase activity is correlated to the clinical stage and PR status, suggestion is made as a parameter for reflecting the progression and prognosis of breast cancer.