Tsujimura Akemi, Kawamura Naoki, Ichimura Tomoyuki, Honda Ken-Ichi, Ishiko Osamu, Ogita Sachio
Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Int J Oncol. 2002 Feb;20(2):361-5.
Preoperative differential diagnoses between uterine sarcomas and leiomyomas are difficult. As telomerase activation is thought to be essential for the immortality of malignant cells, it is considered a potentially useful diagnostic marker. The aim of the present study was to evaluate the potential diagnostic use of measuring telomerase activity in needle biopsy samples to distinguish uterine sarcoma from leiomyoma. Sixty-two patients with suspected uterine sarcomas based on clinical findings or magnetic resonance imaging findings, and who were scheduled for surgery, underwent transcervical ultrasound-guided needle biopsy. Three samples were obtained per patient for histopathological examination and telomerase activity measurement. Telomerase activity was measured using the telomeric repeat amplification protocol and correlated with final histopathological findings of surgical specimens. Of the 62 patients, 6 leiomyosarcomas and 1 endometrial stromal sarcoma (high grade) were diagnosed by histopathology. In 6 of the 7 samples from uterine sarcomas, relatively high telomerase activity (22-102 units) was detected, whereas only low telomerase activity (11-18 units) existed in 3 of the remaining 55 samples from benign or borderline uterine smooth muscle tumors. At a cut-off value of 20 units, sensitivity, specificity, positive predictive, and negative predictive values for detecting uterine sarcoma were 86% (95% confidence interval, 59-100%), 100% (94-100%), 100% (54-100%) and 98% (95-100%), respectively. The results indicated that telomerase activity in needle biopsy samples is a useful diagnostic marker to distinguish uterine sarcoma from leiomyoma.
子宫肉瘤与平滑肌瘤的术前鉴别诊断存在困难。由于端粒酶激活被认为是恶性细胞永生的关键，因此它被视为一种潜在有用的诊断标志物。本研究的目的是评估在针吸活检样本中测量端粒酶活性以区分子宫肉瘤和平滑肌瘤的潜在诊断价值。62例基于临床发现或磁共振成像结果怀疑患有子宫肉瘤且计划接受手术的患者接受了经宫颈超声引导下针吸活检。每位患者获取3份样本用于组织病理学检查和端粒酶活性测定。使用端粒重复序列扩增法测量端粒酶活性，并将其与手术标本的最终组织病理学结果相关联。62例患者中，组织病理学诊断出6例平滑肌肉瘤和1例（高级别）子宫内膜间质肉瘤。在子宫肉瘤的7份样本中的6份中，检测到相对较高的端粒酶活性（22 - 102单位），而在其余55份来自良性或交界性子宫平滑肌肿瘤的样本中的3份中仅存在低水平的端粒酶活性（11 - 18单位）。在截断值为20单位时，检测子宫肉瘤的敏感性、特异性、阳性预测值和阴性预测值分别为86%（95%置信区间，59 - 100%）、100%（94 - 100%）、100%（54 - 100%）和98%（95 - 100%）。结果表明，针吸活检样本中的端粒酶活性是区分子宫肉瘤和平滑肌瘤的有用诊断标志物。
