Eissa Sanaa, Kenawy Gamal, Moteleb Fayda A, El-Makhzangyc Aly Nagy, Nassar Mohamed
Oncology Diagnostic Unit, Medical Biochemistry Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
Clin Biochem. 2005 Oct;38(10):873-8. doi: 10.1016/j.clinbiochem.2005.06.008.
The immortalizing enzyme, telomerase, has been linked to carcinogenesis and is being targeted as a novel molecular marker. This study investigated the pattern of human telomerase reverse transcriptase (hTERT) mRNA by real-time polymerase chain reaction (PCR) in tumor core, edge, and safety margin of laryngeal tumors and related lymph nodes, as well as their relation to the proliferative index (PI) and their impact on prognosis.
This prospective study included 35 patients with laryngeal carcinoma who were surgically treated by total or partial laryngectomy. Collected tissues from tumor core, edge, resection margin, and lymph nodes were examined by flow cytometry and real-time PCR quantification of hTERT mRNA.
The PI showed a statistically significant difference between the contrasted parts (P = 0.04). The highest median for PI was found in the tumor edge samples (31.3), followed by the tumor core (27.5), the resection margin (21.4), and finally the lymph nodes (10.3). There was no significant difference with regard to the ploidy patterns or the synthetic phase fraction (SPF) among the different tissue parts. Real-time PCR hTERT mRNA patterns showed that the highest median for hTERT mRNA level (copies/mug RNA) was in the tumor core (70.5), followed by the tumor edge (36.5), the resection margin (17.3), and finally the lymph nodes (4.4). There was a statistically significant difference with regard to the hTERT mRNA patterns among the different tissue parts (P = 0.04). Tumor differentiation, tumor edge ploidy, and tumor edge hTERT levels were significantly different between survivors and non-survivors, while tumor core S-phase fraction and tumor core PI significantly altered the disease-free survival rate.
hTERT mRNA may potentially be used for molecular reevaluation of the safety margin for conservational laryngeal surgery, and as a prognostic factor for overall survival especially if determined in samples taken from the growing edge of tumors.
永生化酶端粒酶与肿瘤发生有关，正作为一种新型分子标志物被研究。本研究通过实时聚合酶链反应（PCR）检测喉肿瘤及其相关淋巴结的肿瘤核心、边缘及安全切缘中人类端粒酶逆转录酶（hTERT）mRNA的表达模式，以及它们与增殖指数（PI）的关系及其对预后的影响。
本前瞻性研究纳入35例行全喉或部分喉切除术的喉癌患者。通过流式细胞术和hTERT mRNA的实时PCR定量检测从肿瘤核心、边缘、切除切缘及淋巴结采集的组织。
PI在对比部位之间存在统计学显著差异（P = 0.04）。PI中位数最高的是肿瘤边缘样本（31.3），其次是肿瘤核心（27.5）、切除切缘（21.4），最后是淋巴结（10.3）。不同组织部位的倍体模式或合成期分数（SPF）无显著差异。实时PCR检测hTERT mRNA的模式显示，hTERT mRNA水平（拷贝数/μg RNA）中位数最高的是肿瘤核心（70.5），其次是肿瘤边缘（36.5）、切除切缘（17.3），最后是淋巴结（4.4）。不同组织部位的hTERT mRNA模式存在统计学显著差异（P = 0.04）。存活者与非存活者之间的肿瘤分化、肿瘤边缘倍体及肿瘤边缘hTERT水平存在显著差异，而肿瘤核心S期分数和肿瘤核心PI显著改变无病生存率。
hTERT mRNA可能可用于喉保留手术安全切缘的分子重新评估，并作为总生存的预后因素，特别是在取自肿瘤生长边缘的样本中测定时。
