Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2011 May;110(5):275-89. doi: 10.1016/S0929-6646(11)60043-0.
Telomerase activity has been measured in a wide variety of cancerous and non-cancerous tissue types, and the vast majority of clinical studies have shown a direct correlation between it and the presence of cancerous cells. Telomerase plays a key role in cellular immortality and tumorigenesis. Telomerase is activated in 80-90% of human carcinomas, but not in normal somatic cells, therefore, its detection holds promise as a diagnostic marker for cancer. Measurable levels of telomerase have been detected in malignant cells from various samples: tissue from gestational trophoblastic neoplasms; squamous carcinoma cells from oral rinses; lung carcinoma cells from bronchial washings; colorectal carcinoma cells from colonic luminal washings; bladder carcinoma cells from urine or bladder washings; and breast carcinoma or thyroid cancer cells from fine needle aspirations. Such clinical tests for telomerase can be useful as non-invasive and cost-effective methods for early detection and monitoring of cancer. In addition, telomerase activity has been shown to correlate with poor clinical outcome in late-stage diseases such as non-small cell lung cancer, colorectal cancer, and soft tissue sarcomas. In such cases, testing for telomerase activity can be used to identify patients with a poor prognosis and to select those who might benefit from adjuvant treatment. Our review of the latest medical advances in this field reveals that telomerase holds great promise as a biomarker for early cancer detection and monitoring, and has considerable potential as the basis for developing new anticancer therapies.
端粒酶活性已在多种癌症和非癌症组织类型中进行了测量,绝大多数临床研究表明,它与癌细胞的存在之间存在直接相关性。端粒酶在细胞永生化和肿瘤发生中起着关键作用。端粒酶在 80-90%的人类癌中被激活,但在正常体细胞中不被激活,因此,它的检测有望成为癌症的诊断标志物。已经在各种样本中的恶性细胞中检测到可测量水平的端粒酶:来自妊娠滋养细胞肿瘤的组织;来自口腔冲洗液的鳞状癌细胞;来自支气管灌洗液的肺癌细胞;来自结肠腔冲洗液的结直肠癌细胞;来自尿液或膀胱冲洗液的膀胱癌细胞;以及来自细针抽吸的乳腺癌或甲状腺癌细胞。这种端粒酶的临床检测可以作为非侵入性和具有成本效益的早期检测和监测癌症的方法。此外,端粒酶活性已被证明与非小细胞肺癌、结直肠癌和软组织肉瘤等晚期疾病的不良临床结果相关。在这种情况下,检测端粒酶活性可用于识别预后不良的患者,并选择可能受益于辅助治疗的患者。我们对该领域最新医学进展的综述表明,端粒酶作为早期癌症检测和监测的生物标志物具有很大的潜力,并具有作为开发新抗癌疗法的基础的巨大潜力。