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目的 探讨端粒酶活性原位检测在卵巢良、恶性上皮肿瘤诊断与鉴别诊断中的价值。方法 采用端粒酶活性原位检测法 (ISLT法 )和核仁组成区相关蛋白 (AgNORs)技术检测 88例卵巢上皮性肿瘤组织 ,其中囊腺癌 2 6例 ,交界性囊腺瘤 2 1例 ,囊腺瘤 15例 ,囊腺癌癌旁组织 2 6例。结果 卵巢囊腺癌 ,交界性囊腺癌 ,囊腺瘤 ,囊腺癌癌旁组织端粒酶检出率分别为 92 .3% ,4 2 .8% ,0。囊腺癌组端粒酶阳性率与交界性囊腺瘤 ,囊腺瘤 ,囊腺癌癌旁组织存在显著差异 (P <0 .0 1)。其端粒酶阳性检出率与患者年龄 ,肿瘤大小 ,病理类型 ,有无腹水、淋巴结转移 ,分化程度及临床分期无明显相关性 (P >0 .0 5 )。卵巢囊腺癌AgNORs总面积为 0 .92 6 9± 0 .2 0 39μm2 ,与其他组有显著差异 (P <0 .0 1) ,并端粒酶活性强度之间具有显著相关性 (rs=0 .910 ,P <0 .0 1)。交界性囊腺瘤组 9例端粒酶阳性的AgNORs总面积为0 .74 83± 0 .0 36 3μm2 ,12例端粒性酶阴性的AgNORs总面积为 0 .5 870± 0 .1381μm2 ,两者有显著差异 (P <0 .0 1)。结论 LSLT法和AgNORs在卵巢囊腺癌的确诊和交界性囊腺瘤与囊腺瘤的诊断与鉴别诊断中有重要的参考价值。
Objective To investigate the value of in situ detection of telomerase activity in the diagnosis and differential diagnosis of benign and malignant ovarian tumors. Methods Eighty - eight cases of ovarian epithelial tumor tissues were detected by ISLT and AgNORs, including 26 cases of cystadenocarcinoma and 21 cases of borderline cystadenoma , 15 cases of cystadenoma, 26 cases of cystadenocarcinoma adjacent tissue. Results The detection rates of telomerase in ovarian cystadenocarcinoma, borderline cystadenocarcinoma, cystadenoma and cystic adenocarcinoma tissues were 92.3%, 42.8%, respectively. The positive rate of telomerase in cystadenocarcinoma group was significantly different from that in borderline cystadenoma, cystadenoma and cystic adenocarcinoma (P <0.01). The positive detection rate of telomerase had no significant correlation with age, tumor size, pathological type, with or without ascites, lymph node metastasis, degree of differentiation and clinical stage (P> 0.05). The total area of AgNORs in ovarian cystadenocarcinoma was 0.92 6 9 ± 0. 2 0 39μm2, which was significantly different from other groups (P <0.01), and there was a significant correlation between the intensity of telomerase activity (rs = 0 .910, P <0 .0 1). The total area of telomerase positive AgNORs in borderline cystadenoma was 0.7483 ± 0.366μm2, the total area of 12 telomerase negative AgNORs was0.5870 ± 0.1381μm2, There were significant differences (P <0.01). Conclusion LSLT and AgNORs are important in the diagnosis and differential diagnosis of ovarian cystadenocarcinoma and borderline cystadenoma and cystadenoma.