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目的 探讨B超引导下细针穿刺吸收胰腺癌细胞进行端粒酶活性检测在胰腺癌早期诊断的价值。方法 采用TRAP -PCR定性技术对细针穿刺吸收无血管浸润的胰腺癌细胞标本2 8例,有明显血管浸润的胰腺癌细胞标本6例,慢性胰腺炎细胞8例和正常胰腺细胞4例进行端粒酶活性检测,并与组织活检病理及细胞涂片方法相比较。结果 无血管浸润的胰腺癌2 8例中端粒酶表达阳性2 6例,阳性率92 .85 % ;6例有血管浸润的胰腺癌5例阳性,阳性率83 .3 3 % ;8例慢性胰腺炎组织细胞有5例端粒酶表达阳性,阳性率62 .5 0 % ;正常胰腺细胞检测均为阴性。胰腺癌端粒酶活性检测阳性率与血CA19- 9水平无关;胰腺癌的端粒酶活性检测阳性率明显高于细胞涂片阳性检出率,与组织活检病理诊断率无明显差别。结论 胰腺癌细胞中存在端粒酶活性的表达,端粒酶可能能作为一种诊断胰腺癌的肿瘤标志物。B超引导下细针穿刺吸取胰腺细胞进行端粒酶活性检测可能成为一种早期诊断胰腺癌的有效、敏感的方法;与细胞涂片检查相结合可提高胰腺癌的早期确诊率,并且有可能应用于高危人群的检查和胰腺癌治疗疗效评估方面。
Objective To investigate the value of ultrasonography guided fine needle aspiration in pancreatic cancer cells for telomerase activity detection in the early diagnosis of pancreatic cancer. Methods Twenty-eight specimens of pancreatic cancer with fine needle aspiration and pancreatic carcinoma were collected by fine needle aspiration. Six specimens of pancreatic carcinoma with vascular invasion, eight of chronic pancreatitis and four of normal pancreatic cells were performed. Granzyme activity was measured and compared with biopsy pathology and cell smear methods. Results The positive expression rate of telomerase in 26 cases of non-vascular invasive pancreatic cancer was 26.6%, the positive rate was 92.85%. In 6 cases of vascular invasive pancreatic cancer, 5 cases were positive and the positive rate was 83.33%. 8 cases of chronic pancreatitis 5 cases of pancreatitis tissue cells positive expression of telomerase, the positive rate of 62.50%; normal pancreatic cells were negative. The positive rate of telomerase activity in pancreatic cancer had no correlation with the serum CA19-9 level. The positive rate of telomerase activity in pancreatic cancer was significantly higher than that in cell smear, which had no significant difference with the pathological diagnosis rate of tissue biopsy. Conclusion The expression of telomerase activity exists in pancreatic cancer cells. Telomerase may serve as a tumor marker for the diagnosis of pancreatic cancer. B-guided fine needle aspiration of pancreatic cells for telomerase activity testing may be an effective and sensitive method for the early diagnosis of pancreatic cancer; combined with cell smear can improve the early diagnosis of pancreatic cancer, and may be Used in high-risk screening and pancreatic cancer treatment efficacy evaluation.