端粒酶检测对良恶性腹腔积液鉴别诊断价值的探讨

Diagnostic Value of Ascitic Fluid Telomerase Activity in Discriminating Malignancy-Related and Nonmalignant Ascites

目的 检测腹腔积液脱落细胞端粒酶活性 ,探讨端粒酶对良恶性腹腔积液的鉴别诊断价值。方法 运用半定量TRAP -银染法 ,检测 3 8例恶性腹腔积液和 2 0例良性腹腔积液 (对照组 )脱落细胞端粒酶活性。结果 肝硬化、结核性腹膜炎腹腔积液脱落细胞检测未发现端粒酶活性 ,而 3 8例癌性腹腔积液 3 6例 ( 94.7% )端粒酶阳性。所有细胞学检查阳性的恶性腹腔积液端粒酶均为阳性 ,而 3例恶性腹腔积液者 ,细胞学检查阴性但端粒酶阳性 ,当复查细胞学检查时 ,其中 1例发现了癌细胞。结论 癌性腹腔积液端粒酶阳性。端粒酶活性的检测对良、恶性腹腔积液有重要鉴别诊断价值 。

Objective To determine the diagnostic value of telomerase activity in the differential diagnosis between malignancy-related ascites(MRAs) and nonmalignant ascites(NMAs).Methods Telomerase activity was detected by semi-quantitative TRAP assay in 38 patients with MRAs and 20 patients with NMAs.Results Telomerase activity could not be detected in ascites from patients with hepatic cirrhosis and tuberculous peritonitis,but could be detected in 36 of 38 cases with cancerous ascites.All cases with positive cytological examination had positive telomerase activity.Of the peritoneal washing negative cytology cases,telomerase was positive in 3 cases.When the 3 cases were reviewed for peritoneal cytological examination,1 case was diagnosed as malignant ascites.Conclusion Telomesase activity is positive in cancerous ascites.It is useful in the differential diagnosis between MRAs and NMAs,particularly in cases of negative cytology.