端粒酶检测对良恶性腹水鉴别诊断的价值

The differential diagnostic value of telomerase activity in benign and malignant ascites

目的 检测腹水脱落细胞端粒酶活性 ,探讨端粒酶对良恶性腹水的鉴别诊断价值。方法 用半定量TRAP 银染法检测 3 8例恶性腹水和 2 0例良性腹水 (对照组 )脱落细胞端粒酶活性。结果 肝硬化、结核性腹膜炎腹水脱落细胞不能检出端粒酶活性 ,而癌性腹水 94.7%端粒酶阳性。所有细胞学检查阳性的恶性腹水端粒酶均为阳性 ,而 3例细胞学检查阴性但端粒酶阳性的恶性腹水 ,当复查细胞学检查时 ,其中 1例发现了恶性瘤细胞。结论 癌性腹水端粒酶阳性。端粒酶活性检测对良恶性腹水有重要鉴别诊断价值 ,尤其对细胞学检查阴性的患者。

Objective To assess whether telomerase activi ty in ascitic exfoliative cells can be used as an assistant parameter for the diff erential diagnosis of benign and malignant ascites.Methods Telomerase activity was detected by semi-quantitative TRAP assay in 38 patients with various malignant ascites and 20 with benign asc ites.Results Telomerase activity could not be detected in ascites of hepatic cirrhosis and tuberculous peritonitis but could be detected in 36 out o f 38 cancerous ascites.All cases with positive peritoneal washing cytology were telomerase positive.In 3 case with positive telomerase and negative cytology,per itoneal cytology were reevaluate and malignant cell was identified in 1 case.Conclusions Telomerase activity is positive in cancerous ascite s and is useful in differential diagnosis of benign and malignant ascites,partic ularly in cases of negative cytology.