端粒酶检测对良恶性腹水鉴别诊断的价值

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38例恶性腹水和20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。     

结直肠癌组织中人乳头瘤病毒DNA的研究

目的研究１６、１８型人乳头瘤病毒（ＨＰＶ）是否与结直肠癌的发生有关．方法结直肠粘膜活检组织１２３例，其中结直肠癌３５例，乳头状腺瘤１７例，炎性息肉１１例，结肠炎３０例，以及正常结肠粘膜３０例，用对各型ＨＰＶ高度保守的通用引物和１６、１８型特异性引物作聚合酶链反应（ＰＣＲ）检测ＨＰＶＤＮＡ．结果ＨＰＶＤＮＡ总检出率１４６％，正常粘膜，结肠炎和炎性息肉组为３３％（２／７１），乳头状腺瘤为１７６％（３／１７），结直肠腺癌为３７１％（１３／３５）．在正常粘膜，结肠炎和炎性息肉组未发现１６、１８型ＨＰＶＤＮＡ，在乳头状腺瘤组有３例为１８型ＨＰＶＤＮＡ阳性，结直肠腺癌组１３例ＨＰＶ阳性病例中有３例为１６型，９例为１８型感染；在正常组织、癌旁组织和癌组织中ＨＰＶＤＮＡ检出率依次增高．ＨＰＶ在直肠、左半结肠，右半结肠感染率依次为２８６％，１４％，２６％．结论结肠癌的发生与ＨＰＶ１６、１８型有关，腺癌以１８型感染为主．ＨＰＶＤＮＡ检出率在右半结肠，左半结肠和直肠依次增高．     

端粒酶在结肠良、恶性病变中的表达及其意义的研究

目的 研究端粒酶在正常结肠黏膜、结肠良、恶性病变中的表达及其临床意义。方法 收集27例结肠癌，9例结肠良性病变和13例正常肠黏膜的手术标本，用半定量端粒重复扩增（TRAP）-银染法测端粒酶活性，进行统计学处理。结果 结肠正常黏膜、良、恶性病变的端粒酶相对值的组间两两比较均有显著性差异（P〈0．05）。将结肠癌病人分别按病理类型、Duke分期病变体积、部位、病人病程、年龄、性别进行分组，各组间两两比较均没有显著性差异（P〉0．05）。结论 端粒酶是结肠正常黏膜、良性病变、结肠癌相鉴别的较好辅助诊断指标，与结肠癌的一些临床资料无关。     

端粒酶活性检测对良恶性腹水鉴别诊断的价值

目的 通过检测腹水脱落细胞端粒酶活性，探讨端粒酶对良恶性腹水鉴别诊断的价值。方法 用半定量端粒重复序列扩增法(TRAP)，检测38例恶性腹水患者(恶性腹水组)和22例良性腹水患者(良性腹水组)腹水中脱落细胞端粒酶活性。结果 肝硬化、结核性腹膜炎患者腹水中脱落细胞未检出端粒酶，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中端粒酶均为阳性，而3例细胞学检查阴性但端粒酶阳性的恶性腹水，复查细胞学检查，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病例。     

癌性胸水细胞端粒酶活性的检测意义

目的：研究癌性胸水细胞端粒酶活性的检测意义。方法：采用端粒重复序列扩增－核酸杂交分析法检测癌性胸水细胞端粒酶活性，并将检测结果与细胞学诊断进行比较。结果：49例诊断明确的癌性胸水细胞样本中23例细胞学阳性胸水有20例端粒酶阳性，5例细胞学可疑胸水有4例端粒酶阳性，21例细胞学阴性有14例端粒酶阳性。细胞学诊断和端粒酶检测总阳性率分别为46．9％（23／49）和77．6％（38／49），二联合检测率为83．7％（41／49）。结论：胸水细胞端粒酶活性的检测有助于癌性胸水的诊断，弥补胸水细胞学诊断的不足。     

端粒酶活性检测在良恶性腹水鉴别诊断中的价值

目的　检测腹水脱落细胞端粒酶活性,为临床鉴别诊断提供依据。方法　收集各种类型腹水脱落细胞,用ＴＲＡＰＰＣＲＥＬＩＳＡ 银染法检测腹水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８５．２９％ 端粒酶阳性。结论　癌性腹水端粒酶阳性。端粒酶活性检测可作为临床良恶性腹水鉴别诊断依据之一。     

大肠癌组织体内激光诱发荧光光谱分析

目的探讨体内大肠癌与相应正常组织激光诱发荧光（ＬＩＦ）光谱的规律．方法大肠癌患者２１例,癌组织与相应正常组织进行ＬＩＦ光谱检测,同时对每一检测部位取材进行病理组织学检查．结果有１８例患者（８５７％）癌组织与正常组织的ＬＩＦ光谱在强度和形状上不同,选择Ｆ１（ＦＩ４００／ＦＩ５３０,ＦＩ指荧光强度）,Ｆ２（主峰强度）,Ｆ３（主峰波长）３个参数进行比较,癌组织分别为０５７±０２３,３１９２±１５２６,４６５４１±１２４;相应非癌组织分别为１４９±０３６,８９９８±４７０１,４６１０６±０９２,二者Ｆ１,Ｆ２和Ｆ３差异显著（Ｐ＜００１）．诊断大肠癌的敏感性、特异性、阳性预测值和阴性预测值分别为８５７％,７６２％,７８３％和８４２％．结论体内大肠癌与相应正常组织的ＬＩＦ光谱存在明显差异,为进一步临床应用提供了依据．     

胃粘膜活检标本端粒酶活性的检测

为探讨端粒酶活化在胃癌发生发展中的作用，本文采用ＴＲＡＰ法对７２例胃镜胃粘膜活检标本端粒酶活性进行检测，结果发现，胃癌端粒酶阳性率为８５．０％（１７／２０），萎缩性胃炎、肠上皮化生、异型增生及胃腺瘤性息肉端粒酶阳性率分别为２８．６％（１０／３５）、１６．７（１／６）、３３．３％（１／３）及１００％（２／２）。胃癌组织端粒酶阳性率与肿瘤部位、大体类型及组织学分类无明显相关。以上结果提示，胃粘膜活检标本端粒酶活性的检测对阐明胃癌的发生发展过程，胃粘膜癌变的预测及胃癌的早期诊断可能具有重要意义。     

端粒酶活性检测在结肠癌诊断的临床研究

目的通过检测结肠癌及癌周组织标本的端粒酶活性,用于结肠癌诊断的临床研究.方法30例结肠癌外科手术标本及5例结肠腺瘤手术标本,全部结肠癌及距癌肿5cm以上肠粘膜组织.术后行病理组织学检查.全部病例采用TRAP-PCR及ELISA方法检测癌及非癌组织端粒酶活性.将端粒酶活性检测结果与外科手术病理学检测结果进行配对比较.结果25、例结肠癌端粒酶活性检测阳性(83%),癌周组织端粒酶活性检测阳性2例(7%),结肠腺瘤端粒酶活性检测阳性1例(1/5),腺瘤周围粘膜组织端粒酶活性检测阴性.全部病历经手术后病理检查证实为结肠癌或结肠腺瘤.30例结肠癌组织端粒酶活性检测与外科手术病理学检查经配对计数资料的卡方检验,x2=0.57<3.84,P>0.05无显著差异.结论作为一种分子生物学诊断方法,端粒酶活性检测可用于胃癌、结肠癌、肝癌等各种肿瘤的快速诊断,对肿瘤良恶性的鉴别诊断亦有显著的临床意义.肝癌及某些分化良好的肿瘤早期病理学诊断有一定困难.该研究为癌症诊断提供临床应用的可能性.并可为肿瘤的治疗提供疗效依据.     

PCR法诊断幽门螺杆菌感染的评价

目的系统评估聚合酶链反应扩增尿素酶Ａ基因（ＰＣＲ法）对幽门螺杆菌（Ｈｐ）感染的诊断价值．方法采用金标准及ＰＣＲ法检测６９例患者（慢性胃炎５２例、消化性溃疡１２例、胃癌５例）胃粘膜内Ｈｐ．结果金标准诊断有Ｈｐ感染３４例，ＰＣＲ法诊断３５例Ｈｐ阳性；金标准诊断３５例无Ｈｐ感染，ＰＣＲ法诊断３４例Ｈｐ阴性．故ＰＣＲ法敏感度为１００％，特异度为９７１％，粗一致性为９８５％，调整一致性为９８６％，误诊率（假阳性率）为２９％，漏诊率（假阴性率）为０，正确诊断指数（ｒ）为１０，阳性预测值（＋ＰＶ）为９７１％，阴性预测值（ＰＶ）为１００％，阳性似然比（ＬＲ＋）为３５，阴性似然比（ＬＲ）为０．结论ＰＣＲ法对胃粘膜Ｈｐ感染的诊断价值高于细菌培养、组织病理学，尿素酶试验各单项方法．     

Telomerase activity in human bladder tumors and bladder washing specimens

Telomerase appears to be an important factor for the control of cellular proliferation and tumorigenesis. Enzyme activity dramatically increases in almost all human tumors. The purpose of our study was to evaluate the role of telomerase activity as a marker for bladder cancer diagnosis and follow-up. By using the PCR-ELISA based on the TRAP (telomerase repeat amplification protocol) method, telomerase activity of bladder tumors (n = 77), normal-appearing adjacent tissues (n = 21) and bladder washings (n = 37) were analyzed. Telomerase activity was detected in 87% (67/77) of cancer tissues and in 38% (8/21) of normal-appearing adjacent tissues. However, the levels of enzyme activity were significantly higher in cancer tissues than in normal-appearing adjacent tissues (p < 0.05). Telomerase activity in bladder cancer tissues was not correlated to the tumor stage or grade. During a 26 months follow-up period, disease progression occurred in 66.7% of patients with invasive tumors where telomerase activity of the normal-appearing adjacent tissue was detectable, as compared to only 14.3% for patients who showed undetectable telomerase activity in adjacent, normal-appearing tissues (p = 0.094). When telomerase activity of bladder washing fluid was compared with its corresponding tumors, sensitivity of detection was 81% and specificity was 75%. In contrast, urine cytology only yielded a sensitivity of 31% in the detection of cancer. The detection ability between telomerase activity measurement in washing fluid and cytological examination had a trend toward the telomerase measurement identifying more cancer cases than the cytologic examination (p = 0.07). In conclusion, telomerase activity is present in early-stage bladder cancer and is a potential molecular marker for bladder tumors diagnosis. The expression of telomerase activity in normal-appearing mucosa adjacent to bladder tumor is probably an indicator of disease progression. Using the telomerase activity to detect exfoliated cells in bladder washing fluids could be a useful method in adjunct to urine cytology and cystoscopy in establishing the diagnosis and follow-up of bladder cancer.     

Detection of telomerase activity in biopsy samples of colorectal cancer

BACKGROUND: Telomerase is a ribonucleoprotein that synthesizes telomeric DNA onto chromosomal ends. The expression of telomerase is thought to be required for cellular immortality and oncogenesis. METHODS: To investigate the role of telomerase in the pathogenesis of colorectal cancer, we analysed telomerase activity in biopsy samples of colorectal cancer and colonic adenomas. Using a polymerase chain reaction-based assay, we examined telomerase activity in 52 samples of colorectal cancer, 12 colonic adenomas and 30 normal colonic mucosa samples obtained by endoscopic biopsy. RESULTS: Telomerase activity was detectable in 88.5% (46/52) of colorectal carcinomas, in 50% (6/12) of colonic adenomas but not in normal colorectal mucosa. There was no correlation between telomerase activity and tumour location, type, size and differentiation (P > 0.05). CONCLUSIONS: It was concluded that telomerase activation plays a role in the evolution of colorectal cancer, and that measurement of telomerase activity in biopsied colorectal mucosa samples may provide information both as a diagnostic marker to detect small numbers of cancer cells, and as a screening method for patients at high risk for colorectal carcinoma.     

Telomerase as a diagnostic and predictive marker in colorectal carcinoma

In a search for molecular markers providing both informative diagnostics of malignant disease, and rational stratification of a therapeutic strategy to achieve optimal response in a given patient, we examined the possibility of using telomerase for this purpose in colorectal cancer. Telomerase, a ribonucleoprotein enzyme complex catalysing synthesis of chromosome ends (telomeres), has been known as an almost universal tumor marker but its predictive value has been found in only a limited number of malignant tumor types. Telomerase activity and expression of its catalytic subunit hTERT was determined in 82 surgical specimens from 41 patients (a sample of tumor tissue and of adjacent morphologically normal tissue was obtained from each patient). Telomerase activity was present in tumor samples from 34 (83%) patients, reaching an average value of 47.6 telomerase units (T.U.), while adjacent tissue specimens were either negative (in 25 (61%) patients), or slightly positive (in 16 (39%) patients) showing 1.5 T.U. on average. In tumor samples from patients without lymphatic node metastases (pN0), an average of 37.1 T.U was found. In contrast, in tumor samples from patients with lymphatic node involvement (pN1 or pN2) the average activity was significantly higher (60.2 T.U., p<0.05). In patients with distant metastases a tendency towards higher telomerase activity, although lacking statistical significance, could be observed. Among patients that obtained chemotherapy with 5-fluoruracil, those with low telomerase activity showed a tendency to chemosensitivity. Expression of hTERT was detected not only in samples showing telomerase activity, but also in a considerable portion of telomerase-negative samples either from the tumor or the adjacent normal tissue. We demonstrate that some of these apparent discrepancies may be attributed to differential splicing of hTERT mRNA. We conclude that TRAP assay for telomerase activity is more informative than the common testing for hTERT expression. Telomerase activity is useful both as a diagnostic as well as a predictive factor in colorectal cancer.     

Deficiency of colonic telomerase in ulcerative colitis

OBJECTIVE: GI epithelial cells express telomerase, a ribonucleoprotein that prevents telomeric shortening in proliferating cells. Telomerase levels are high in cancer, but little is known about telomerase expression in other diseases. We, therefore, designed experiments to determine telomerase expression in different colonic segments and to compare this with corresponding segments in patients with ulcerative colitis. Colorectal cancers and adenomatous polyps were included as disease controls. METHODS: In total, telomerase expression was determined in colonic tissues obtained from 62 patients. Twenty-five patients had ulcerative colitis, 21 had normal colons, 11 had colorectal cancer, and nine had adenomatous polyps. Endoscopic biopsies were collected prospectively at colonoscopy, processed for telomerase assays (Telomeric Repeat Amplification Protocol), hematoxylin and eosin staining, and scored for inflammation. RESULTS: Telomerase activity is expressed in arbitrary units (median 95% confidence interval). In the normal colon, telomerase activity in the cecum, transverse, sigmoid, and rectum was 255 (171-449), 707 (374-895), 561 (468-1426), and 563 (402-846), respectively. Telomerase was higher in the distal three segments when compared with the cecum (p = 0.005). In ulcerative colitis, there was a marked decrease in telomerase activity in the cecum 152 (59-272), p = 0.04, transverse 180 (129-365), p < 0.001, sigmoid 352 (114-464), p = 0.005, and rectum 180 (70-337), p = 0.001 when compared with normals. Telomerase activity correlated negatively with inflammation (r = -0.32, p = 0.001) and was also decreased in microscopically normal areas. Cancers expressed high levels of telomerase. CONCLUSIONS: Colonic mucosal expression of telomerase is reduced in ulcerative colitis. Levels are low even in microscopically normal mucosa, suggesting that telomerase deficiency may contribute to the pathogenesis of the disease.     

Detection of telornerase activity and cytology in diagnosis of cardiac cancer

AIM To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells ofcardia obtained from endoscopic brushing in the cardiac cancer.METHODS The techniques of the qualitative TRAP-silver staining and quantitative TRAP-PCR-ELISAwere employed to detect telomerase activity in the exfoliated cells of cardia obtained from endoscopicbrushing in 72 cases with cardial lesions, cytological diagnosis was made at the same time.RESULTS Telomerase activity with cardiac cancer group (1.521 ± 0. 192) was significantly higher than thatwith cardialitis group (0.065± 0.014). Positive rate of telomerase activity detected in cardiac cancer group(88.89%) was significantly higher than that with cardialitis group (11.11%), the former was significantlyhiger than cytological examination (77.78%). The diagnostic rate of cardiac cancer reached 93.33% iftelomerase activity and cytology were examined at the same time.CONCLUSION Cytology and telomerase activity in the exfoliated cardiac cells may be an effective andsensitive methods in the diagnosis of cardiac cancer. This research can be a basis for the mass screening ofcardiac cancer.     

膀胱癌组织端粒酶活性表达及其与临床病理特征关系的研究

目的 探讨膀胱移行细胞癌（transitional cells carcinoma,TCC）组织端粒酶活性表达与膀胱癌临床病理特征的关系.方法 应用端粒酶重复序列扩增（telomeric repeat amplification protocol,TRAP）银染TRAP-ELISA方法检测25例膀胱癌组织（实验组）和4例膀胱正常组织（对照组）中端粒酶活性的表达,并与临床病理分期、病理分级及预后关系进行分析.结果 实验组中端粒酶活性表达率为96%,对照组无表达,实验组端粒酶活性高于对照组（P＜0.001）;端粒酶活性临床病理分期T2高于T1、T3高于T2（P＜0.01）,晚期组高于早期组（P＜0.001）;端粒酶活性病理分级G2高于G1、G3高于G2（P＜0.01）.结论 实验组端粒酶活性高表达,并与膀胱癌临床病理分期、病理分级呈正相关,端粒酶激活可能在膀胱癌的发生及发展过程中起重要作用,端粒酶可作为膀胱癌早期诊断及判定预后的分子生物学标记.     

Telomerase Activity is a Prognostic Factor for Recurrence and Survival in Rectal Cancer

PURPOSE: This study was designed to determine whether telomerase activity measured in samples of tumoral tissue, transitional mucosa, and normal mucosa from patients with sporadic colorectal cancer is a prognostic factor for recurrence and overall survival. METHODS: Telomerase activity was determined by fluorescence-based telomeric repeat amplification in tissue samples from 108 patients with sporadic colorectal cancer. A telomerase index was determined by using the formula log (telomerase activity of cancer tissue - telomerase activity of normal mucosa). RESULTS: Mean telomerase activity in tumoral tissue was 11.49 (total product generated), in transitional mucosa it was 1.51, and in normal mucosa it was 1.09 (P < 0.001). Telomerase activity and telomerase index were not correlated with clinicopathologic factors. Rectal cancer patients' recurrence-free survival was related to N classification (P = 0.004) and to tumor-node-metastases stage classification (P = 0.023) and telomerase index 0.85 (P = 0.023). Overall survival was associated with N classification (positive/negative) and telomerase index (0.85; P = 0.018 and P = 0.011, respectively). CONCLUSIONS: Measurement of telomerase activity has a diagnostic value in colorectal patients. In rectal cancer, telomerase index is an independent prognostic factor for disease progression. A telomerase index相似文献