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目的 探讨端粒酶作为肺癌肿瘤标记物的可能性 ,评价端粒酶活性对肺癌的早期诊断价值。方法 采用改良银染 -端粒重复序列扩增法 (TRAP)检测 40例原发性支气管肺癌手术标本及 40例CT扫描疑诊为肺癌患者的纤维支气管镜活检标本的端粒酶活性。结果 两组中小细胞肺癌端粒酶阳性率均为 10 0 % ,非小细胞肺癌分别为 84.8%、95 .7%。 40例手术切除肺癌组织的端粒酶阳性率为 87.5 % ( 3 5 /40 ) ,癌旁肺组织为7.5 % ( 3 /40 ) ,正常肺组织无表达 ( 0 /40 ) ,三组间比较有显著性差异 (P <0 .0 1)。 40例CT扫描疑诊为肺癌患者的纤维支气管镜肺活检标本的端粒酶阳性率为 82 .5 % ,肺癌检出的敏感度为 96.4% ,特异度为 71.4% ,准确性为 91.4% ;尤登指数 (Youden’sIndex)J =0 .678,SE(J) =0 .174。结论 端粒酶是灵敏的肺癌肿瘤标记物 ,对纤维支气管镜活检标本行端粒酶活性检测有助于肺癌的早期诊断。
Objective To explore the possibility of telomerase as a tumor marker for lung cancer, and to evaluate the early diagnostic value of telomerase activity in lung cancer. METHODS: Modified telomere-telomer repeat amplification (TRAP) was used to detect telomerase activity in 40 patients with primary bronchogenic lung cancer and 40 patients with suspected lung cancer who underwent CT scanning. Results The positive rates of telomerase in both groups were 100%, and non-small cell lung cancer was 84.8% and 95.7%, respectively. The positive rate of telomerase in 40 lung cancer tissues was 87.5% (35/40), 7.5% (3/40) in adjacent lung tissues, and 0/40 in normal lung tissues. There was a significant difference (P < 0.01). The positive rate of telomerase in lung biopsy specimens of 40 lung cancer patients with CT scan was 82.5%, the sensitivity of lung cancer was 96.4%, the specificity was 71.4%, and the accuracy was 91.4%. Youden’s Index J =0.678, SE(J) =0.174. Conclusion Telomerase is a sensitive tumor marker for lung cancer. Detection of telomerase activity in fiberoptic bronchoscopy biopsy specimens is helpful for the early diagnosis of lung cancer.