食管鳞状上皮不典型增生中端粒酶逆转录酶的表达

Expression of telomerase reverse transcriptase in premalighnant esoph ageal squamous dysplasia

目的 探讨端粒酶逆转录酶 (hTRT)与食管黏膜鳞状上皮不典型增生恶性转化的关系及其作用。方法 应用端粒末端重复序列扩增技术 (telomericrepeatamplificationprotocol,TRAP)和原位杂交技术检测 47例食管黏膜鳞状上皮不典型增生患者组织、2 9例食管鳞癌患者组织及 11例正常组织标本中端粒酶活性及其hTRTmRMA的表达。结果 正常组织标本均未检测出端粒酶活性 ,食管黏膜鳞状上皮不典型增生组端粒酶活性检出率为 44.7% ( 2 1 47) ,显著高于正常组 ( χ2 =5.89,P <0 .0 5) ;食管鳞癌组端粒酶活性检出率为 86.2 % ( 2 5 2 9) ,显著高于不典型增生组 ( χ2 =11.3 5,P <0 .0 1)。正常组织hTRTmRMA无表达 ,不典型增生组阳性表达率为 48.9% ( 2 3 47) ,显著高于正常组( χ2 =6.99,P <0 .0 1) ;食管鳞癌组阳性表达率为 82 .8% ( 2 4 2 9) ,显著高于不典型增生组 ( χ2 =7.3 2 ,P <0 .0 1)。hTRTmRMA表达与端粒酶活性显著相关 ( χ2 =57.91,P <0 .0 0 1)。结论 hTRTmRNA表达与端粒酶活性呈高度一致性 ,提示hTRT在端粒酶活性调节中可能起关键性作用 ,并与食管黏膜鳞状上皮不典型增生细胞恶性转化密切相关 ,hTRT有望成为食管鳞癌的新的、有价值的生物标志物。

Objective To study the relationship of hu ma n telomerase reverse transcriptase (hTRT) and malignant transformation of esopha geal dysplasia. Methods Telomerase activity and hTRT expression in esoph ageal dysplasia ( n= 47),squamous cell carcinoma ( n= 29) and normal esophagus ( n= 11) were detected by telomeric repeat amplification protoc ol (TRAP) and in situ hybridization,respectively. Results Telomerase activity was detected in none of th e 11 cases of normal esophageal tissues (0%) but in 21 of 47 cases ( 44.7 %) of dysplasia, and in 25 of 29 cases ( 86.2 %) of esophageal squamous cell car cinoma. There were statistically significant differences among the telomerase ac tivit y in normal esophagus,esophageal dysplasia,and in squamous cell carcinoma ( χ 2= 5.89 , P< 0.05 ; χ 2= 11.35 , P< 0.01 ). hTRT mRNA was expressed in none of the 11 cases of normal esophageal tissues ( 0%) but in 23 of 47 cases ( 48.9 %) of dysplasia,and in 24 of 29 cases ( 82. 8 %) of esophageal squamous cell carcinoma. There were statistically significa nt differences among the expression of hTRT mRNA in normal esophagus,esophageal dysplasia, and in squamous cell carcinoma ( χ 2= 6.99 , P< 0. 01 ; χ 2= 7.32 , P< 0.01 ). Significant correlation was fo und between the telomerase activity and the expression of hTRT mRNA ( χ 2= 57.91 , P< 0.001 ). Conclusion The mRNA expression of hTRT which paralleled t o telomerase activity implied that there was a crucial role to play in regulati ng the activation of telomerase,and was closely related to the malignant transfo rmation of esophageal dysplasia.hTRT might serve as a new,valuable biomarker to detect esophageal squamous cell carcinoma.