外周血hTERT在膀胱尿路上皮癌中的意义

The significance of hTERT in peripheral blood of patients with bladder urothelial carcinoma

目的通过检测膀胱尿路上皮癌患者血液中hTERT的含量,探究其在疾病诊断和复发病例中的意义及应用价值。方法利用RT-PCR技术,检测膀胱尿路上皮癌患者外周血中hTERT的含量,并将数据进行比较分析。结果膀胱尿路上皮癌患者血液标本的hTERT的阳性率为60.7%(34/56),正常人阳性率为0(0/30)。hTERT的含量在病理分级高级别与中低级别之间、临床分期T2～T4(浸润性)与Tis～T1(非浸润性)之间的差异有统计学意义(P<0.01)。膀胱尿路上皮癌复发的患者血液中hTERT的含量与原发的患者比较,差异无统计学意义(P>0.05)。结论 hTERT可以作为患者外周血存在循环肿瘤细胞的重要标志,运用RT-PCR技术检测血液标本中hTERT的含量,可对是否存在微转移做出判断,其在血液中的含量与病理分级和临床分期相关,与是否复发无关。

Objective To explore the significance of hTERT level in the peripheral blood of patients with bladder urothelial carcinoma in diagnosis, disease recurrence and its application. Methods The levels of hTERT in peripheral blood were ex- amined by RT-PCR from bladder urothelial carcinoma patients in different pathological grades and clinical stages. Com- pared and analyzed the results. Results The peripheral blood hTERT was positive in 60.7% （34/56） bladder urothelial car- cinoma patients. None of healthy donors was found hTERT in their peripheral blood. The hTERT level in peripheral blood of patients was different between pathological grade of high-level and low-level. The difference between clinical stage T2-T4 （invasive） with Tis-T1 （non-invasive） was also significant （P 〈 0.01）. The difference between patients with recurrent blad- der urothelial carcinoma and primary patients was not significant （P 〉 0.05）. Conclusion High levels of peripheral blood hTERT in patients with bladder urothelial carcinoma indicate circulating tumor cells being existed in patients＇ blood. To detect the level of hTERT by RT-PCR in peripheral blood of patients with bladder urothelial carcinoma can provide sup- port for finding the micrometastasis in blood. The level of hTERT is correlated with pathological grade and clinical stage. The difference of hTERT levels between recurrent and primary patients is not significant.