Braunschweig R, Yan P, Guilleret I, Delacretaz F, Bosman F T, Mihaescu A, Benhattar J
Institut de Pathologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Diagn Cytopathol. 2001 Mar;24(3):174-80. doi: 10.1002/1097-0339(200103)24:3<174::aid-dc1036>3.0.co;2-8.
Telomerase is inactive in most somatic cells, but has been found to be reactivated in a majority of cancers. Our principal goal was to test whether the presence of telomerase activity concurred with positive cytology, and was thus of potential use in detecting cancer cells in effusions. The telomeric repeat amplification protocol (TRAP) assay and cytological examination were performed in a blinded fashion on 91 unselected effusions, for which laboratory processing was done according to standard procedures. In our series, 30% (27/91) of samples were found to be malignant by cytology. Of these, 19 (70%) were also positive in the TRAP assay. Of the 8 telomerase-negative cytology-positive samples, RNA integrity was generally poor, indicating suboptimal sample conservation for molecular analysis. Negative cytology in the presence of telomerase activity was observed in 17 effusions. Of these, 11 were from patients with advanced cancer, and thus a diagnosis of malignant effusion should be suspected. The TRAP assay for telomerase activity holds promise in the analysis of effusions, but its routine use as an adjunct to cytology awaits further confirmation of its positive predictive value.
端粒酶在大多数体细胞中无活性，但已发现在大多数癌症中被重新激活。我们的主要目标是测试端粒酶活性的存在是否与阳性细胞学结果一致，因此是否可用于检测积液中的癌细胞。端粒重复序列扩增法（TRAP）检测和细胞学检查以盲法对91例未经选择的积液进行，这些积液的实验室处理按照标准程序进行。在我们的系列研究中，30%（27/91）的样本经细胞学检查发现为恶性。其中，19例（70%）在TRAP检测中也呈阳性。在8例端粒酶阴性但细胞学阳性的样本中，RNA完整性普遍较差，表明用于分子分析的样本保存欠佳。在17例积液中观察到端粒酶活性存在但细胞学阴性的情况。其中，11例来自晚期癌症患者，因此应怀疑为恶性积液。TRAP法检测端粒酶活性在积液分析中有应用前景，但其作为细胞学辅助手段的常规应用有待进一步证实其阳性预测价值。
