膀胱移行上皮癌组织端粒酶活性的检测及意义

Study of telomerase activity in transitional cell carcinoma of the bladder

目的：为了探讨端粒酶与膀胱移行上皮癌（ＴＣＣ）及其生物学行为的关系。方法：应用端粒酶重复序列扩增法（ＴＲＡＰ法）检测４２例ＴＣＣ组织及１２例正常膀胱粘膜组织的端粒酶活性，并分析端粒酶活性与ＴＣＣ病理分化程度、浸润深度、肿瘤发生的多中心性及肿瘤复发等生物学行为的关系。结果：ＴＣＣ组织中端粒酶活性阳性率为８５．７％（３６／４２），而正常膀胱粘膜组织端粒酶活性阳性率为０．０％（０／１２），两者比较有显著的统计学差异（Ｐ＜０．０１）；不同病理分化程度、浸润深度及单发或多发ＴＣＣ组织中的端粒酶活性阳性率无显著的统计学差别（Ｐ均＞０．０５）；术后肿瘤复发者的端粒酶活性阳性率为１００％（８／８），而未复发者的端粒酶活性阳性率为８２．３％（２８／３４），两者比较有显著的统计学差异（Ｐ＜０．０５）。结论：本实验结果表明ＴＣＣ组织中端粒酶活性阳性率明显高于正常膀胱粘膜组织，术后肿瘤复发者的端粒酶活性阳性率明显高于未复发者。而ＴＣＣ病理分化程度、浸润深度及肿瘤发生的多中心性等生物学行为与端粒酶活性未见有相关性。因此，端粒酶活性有可能作为ＴＣＣ早期诊断、鉴别诊断及预测肿瘤复发的标志物。

Objective: To investigate telomerase activity in transitional cell carcinoma of the bladder (TCC) and its relationship to the biological malignant potentials of TCC. Methods: Using polymerase chain reaction-based telomeric repeat amplification protocol assay, we examined telomerase activity in 42 TCC tissues and 12 normal bladder tissues. Results: Telomerase activity was detected in 36 of 42 (85. 7% ) TCC tissues, and none of 12 normal bladder tissues (0. 0% ), the positive rate of telomerase activity in TCC was significantly higher than that in normal bladder tissues (P < 0. 01 ). There was a correlation between the positive rate of telomerase activity and the status of tumor recurrence (P < 0.05), but unexpectedly, no significant correlation was observed between the positive rate of telomerase activity and the clinicopathologic features of TCC, including pathologic grade, clinical stage and tumor mutiplicity (P > 0. 05). Conclusions: This study suggests that telomerase activition may be a critical step in the pathogenesis of TCC and that telomerase activity might be a useful tool for detecting TCC and predicting recurrence of TCC; but there was no significant correlation between telomerase activity and the clinicopathologic features of TCC, although further studies are required to clarify this point.