肺癌纤维支气管镜标本端粒酶活性的检测

Detection of Telomerase Activity in Bronchoscopic Samples in Lung Cancer Patients

目的：探讨纤维支气管镜检查活检、刷检标本端粒酶活性检测对肺癌诊断的价值。方法：应用TRAP－PCR－ELISA方法检测39例纤维支气管镜活检标本、29例刷检标本端粒酶活性并分析其诊断肺癌的价值。结果：24例肺癌活检标本端粒酶活性水平与癌疑组相近，但明显高于炎症组。端粒酶活性的检测敏感性为83．3％，特异性为80．0％，准确性为82．1％。不同病理类型肺癌的端粒酶活性阳性检出率差异无显著性。刷检标本中端粒酶活性阳性检出率58．3％，端粒酶活性阳性标本的端粒酶活性水平在不同病理分型间差异无显著性，而病理分级组间有显著差异。结论：端粒酶活性是肺癌诊断的分子生物学标志物之一。与组织细胞学检查相结合可提高肺癌的早期诊断率。

Objective： To investigae the diagnostic significance of detecting telomerase activity in bronchoscopic brush－off cells and biopsy tissues from patients with lung cancer． Methods： The technique of TRAP－PCR－ELISA was employed to detect telomerase activity in 39 biopsy samples and 29 samples of brush－off cells in patients with lung cancer or inflammation， and its significance in diagnosis of lung cancer was discussed． Results： The positive rate and levels of telomerase activity in 24 biopsy samples of lung cancer group were as same as those in 4 biopsy samples from suspected lung cancer patients （P＞0．05）， but were significantly higher than that in inflammation group （P＜0．001）． The sensitivity， specificity and accuracy rates of detection of telomerase activity were 83．3％， 80．0％， 82．2％ respectively． There was no significant difference in positive rates of telomerase activity between the different pathologic types． Positive rate of detecting telomerase activity in bronchoscopic brush－off cells was 58．3％． Within the telomerase activity positive samples， no significant difference of telomerase activity was found between different pathologic types（P＞0．05）， but it was found between different differentiation groups （P＜0．005）． Conclusion： The telomerase activity may be used as a good marker for diagnosis of lung cancer． Combined with pathologic analysis， it is possible to raise the early diagnostic rate of lung cancer．