膀胱癌尿脱落细胞端粒酶活性检测及其意义

DETECTION OF TELOMERASE ACTIVITY IN EXFOLIATED CELLS IN URINE SAMPLES FROM PATIENTS WITH BLADDER CANCER

目的 研究端粒酶对膀胱癌的诊断价值。方法 应用端粒重复扩增 (TRAP) 微孔板杂交法测定 58例膀胱癌患者肿瘤组织及尿液、膀胱冲洗液脱落细胞的端粒酶活性 ,并与细胞学检查作比较。结果 肿瘤组织标本中 ,端粒酶阳性率为81 0 3 % ;尿液标本中 ,阳性率为 57 14 % ;膀胱冲洗液标本中 ,阳性率为 70 3 7%。同期尿细胞学检查 ,阳性率仅 3 6 2 1%。在低级别肿瘤中 ,尿或膀胱冲洗液端粒酶阳性率明显高于细胞学检查。结论 膀胱癌组织有端粒酶活性的高表达 ,而尿液、膀胱冲洗液脱落细胞中有较高的端粒酶活性检出率。

Objective: To find a more sensitive and specific noninvasiv e assay for the detection of bladder carcinoma. Methods: Spontaneo usly voided urine specimens and bladder-washing fluids were taken from 58 patie nts with bladder cancer. Telonerase activity was examined by means of telomere r epeat amplification protocol(TRAP) and microtiter plate hybridization. Standard cytologic eramination (H.E staining)of urine specimens was also used to detect e xfoliated cancer cells. Results: Telomerase activity was found i n 47(81 03%) of the 58 tumor samples. Telomerase was detected in exfoliated cel ls in 32(57 14%)of the 56 urine specimen and in 38(70 37%) of the 54 bladder- washing fluids examined. Cancer cells were detected by means of standard cytolog ic examination in the urine of 21(36 21%) of the 58 patients. Telomerase activi ty appears to be more sensitive in the presence of the low grade bladder carcino ma than standard urine cytologic examination. Conclusion: These findings suggest that measuring telomerase activity in exfloiated cells would be useful in the diagnosis and follow-up of patients with bladder cancer.