脑膜瘤端粒酶的活性在判断复发和恶变中的价值

Value of Telomerase Activity of Meningiomas on Identifying Recurrence and Malignancy

【目的】探讨端粒酶作为脑膜瘤标志物 ,在肿瘤良恶性鉴别、恶性程度评估以及预后预测等方面的意义。【方法】利用TRAP ELISA方法定量检测 6 1例 (份 )肿瘤标本端粒酶的活性 (以ΔA =A4 50 -A690 表示 ) ,结合肿瘤的分类和患者的临床资料 ,分析端粒酶活性作为肿瘤良恶性及判断预后的标记物的可行性。另取正常脑组织标本 2 0例作为对照。【结果】 30例脑膜瘤中 ,2 9例脑膜瘤均未测到端粒酶活性 ;1例端粒酶阳性 (阳性率 3 3%) ,ΔA =0 2 37;全组ΔA平均值 =0 0 49。 15例恶性脑膜瘤中 14例呈端粒酶阳性 (93%) ,ΔA =1 2 37～ 2 5 16 ;1例端粒酶阴性 ,ΔA =0 0 76 ,全组ΔA平均值 =1 6 30。 16例复发性脑膜瘤端粒酶均阳性 (10 0 %) ,ΔA =1 0 34～ 1 4 78,平均 1 2 5 5。脑膜瘤和复发性脑膜瘤、脑膜瘤和恶性脑膜瘤的端粒酶的阳性率和酶活性表达强度方面差异明显 (P分别为 <0 0 0 1、<0 0 1和 <0 0 0 0 5、<0 0 1)。 2 0例正常脑组织中未检测到端粒酶活性。【结论】端粒酶活性的激活在恶性脑膜瘤和复发性脑膜瘤中是较常见的现象。端粒酶作为肿瘤标志物 ,在脑膜瘤的良恶性鉴别、恶性程度评估、预后预测等方面具有重要的意义。

Objective To explore telomerase activity in meningiomas and its significance in tumor's classification, evaluation of malignancy and prognosis. Methods Telomerase activity of meningiomas (expressed as ΔA=A 450 -A 690 ) was detected quantitatively using telomerase polymerase enzyme linked immunoassay (TRAP-ELISA). Combining with the data, such as tumors histopathological classification and patients' clinical materials, the possibility of telomerase served as tumor marker for differentiating benign and malignant, evaluating malignancy, predicting prognosis in meningioma were discussed. Results Telomerase was only detected positively in one of 30 meningiomas(positive rate:3.3%), ΔA=0.237; average ΔA=0.049. In contrast, 14 of 15(93%) malignant meningiomas were positive for telomerase expression, average ΔA=1.630. In the 16 recurrence meningiomas, all were positive for telomerase expression, average ΔA=1.255. Positive rate for telomerase expression and average value were significant different between meningiomas and recurrent meningiomas(P<0.001 and P<0.01), and also different between meningiomas and malignant meningiomas(P<0.0005 and P<0.01). Telomerase activity was not detected in 20 normal brain tissues. Conclusion Activation of telomerase activity is a common phenomenon in malignant meningiomas. It is an important marker for differentiating benign and malignant, evaluating malignancy and predicting prognosis.