端粒酶检测应用于乳腺癌术前诊断的价值

The value of telemerase activity detection in diagnosis of breast cancer before operation

目的 探讨端粒酶活性检测在临床的应用价值。 方法 在 118例乳腺肿块患者中 ,分别比较了术前细针穿刺端粒酶活性检测和细胞学检查两种检测方法在乳腺癌中的诊断率 ,以及两种方法联合诊断乳腺癌诊断率。并对乳腺肿瘤端粒酶活性表达与乳腺肿瘤生物学特性的相关性进行了研究。 结果 端粒酶检测同细胞学检查相比灵敏度显著高于后者 (85 4%vs.6 7 1% ,P <0 0 5 ) ;而特异性 (72 2 %vs.86 1% )、约登指数 (5 7 6 %vs .5 3 2 % )、阳性预测值 (87 5 %vs.91 7% )差异均无显著性意义。两种方法联合诊断的阳性预测值为 10 0 % ,显著高于阳性预测值较高的细胞学检查(P <0 0 5 )。在乳腺癌中 ,端粒酶活性表达与雌激素受体、孕激素受体表达显著相关 (χ2 =5 0 3,P <0 0 5 ) ,与患者年龄 (χ2 =0 6 5 )、肿瘤直径 (χ2 =0 6 5 )、腋淋巴结转移情况 (χ2 =0 16 )无显著相关性 (P >0 0 5 ) ,在乳腺良性病变中 ,乳腺纤维腺瘤和乳腺病的端粒酶活性表达率显著高于其他病变 (χ2 =3 94,P <0 0 5 )。

Objective[WT5”BZ] To evaluate telomerase activity detection in the diagnosis of breast cancer before operation. [WT5”HZ]Methods[WT5”BZ] 118 breast masses were aspirated by fine needles. Part of the sample was subjected to cytomorphology and the other to detection of telomerase activity. The two methods were compared clinically, and their combination or single application. The relationship between telomerase activity expression and biological characteristics of breast tumors was studied. [WT5”HZ]Results[WT5”BZ] Compared with cytomorphology under microscope, preoperative telomerase activity detection′s sensitivity was significantly higher (85 4% vs. 67 1%, P <0 05); its specificity(72 2% vs.86 1%),Youden′s index (57 6% vs. 53 2%) and positive predict value(87 5% vs 91 7%) were not significantly different( P >0 05). When both results were positive, the positive predicting value was 100%. There was no significant relationship between telomerase activity, age(χ 2=0 65), tumor diameter(χ 2=0 65), axillary lymph node metastasis(χ 2=0 156) ( P >0 05); but there was a significant relationship between telomerase activity, ER, PR (χ 2=5 03, P <0 05). In breast benign disease, telomerase activity of breast fibroma and mastosis were significantly higher than in other diseases (χ 2=3 94, P <0 05). [WT5”HZ]Conclusion[WT5”BZ] Telomerase activity detection of the samples obtained by fine needle aspiration from breast masses is of practical value in preoperative diagnosis of breast cancer. [WT5”HZ]