Yokota K, Kanayama H, Kagawa S, Abe-Hashimoto J, Hirose M, Yoshimura T
Department of Urology, School of Medicine, University of Tokushima.
Nihon Rinsho. 1998 May;56(5):1292-8.
Voided urine cytology is the most common non-invasive examination for the detection and monitoring of bladder cancer. However, the result is not satisfactory, especially for low grade tumors. Activity of telomerase can be detected in most tissues of bladder carcinoma using the telomeric repeat amplification protocol (TRAP) assay. We analyzed the quantitative telomerase activity in exfoliated urothelial cells, and evaluated the values for early diagnosis of bladder carcinoma. We performed a quantitative analysis using a hybridization protection assay (HPA) based on TRAP assay. Telomerase activity was significantly higher level in exfoliated urothelial cells from patients with bladder cancer than all of healthy cases and patients with benign disease (p < 0.0001). The cut off value was calculated as mean + 2SD of the telomerase activity level of the exfoliated urothelial cells from healthy cases. Using this cut off value, telomerase activity was positive in 26 of 41 in exfoliated urothelial cells from bladder cancer patients(63.4% sensitivity), and negative in 63 of 69 in exfoliated urothelial cells from healthy cases and patients with benign disease (91.3% specificity). The sensitivity of telomerase activity in exfoliated cells was higher than urinary cytology, especially in low grade tumors. Our results indicate that quantitative analysis of telomerase activity in exfoliated urothelial cells could become minimum invasive and useful method for detection of bladder carcinoma.
尿脱落细胞学检查是检测和监测膀胱癌最常见的非侵入性检查方法。然而，其结果并不令人满意，尤其是对于低级别肿瘤。使用端粒重复序列扩增法（TRAP）检测，大多数膀胱癌组织中均可检测到端粒酶活性。我们分析了脱落尿路上皮细胞中端粒酶的定量活性，并评估了其在膀胱癌早期诊断中的价值。我们基于TRAP检测，采用杂交保护分析法（HPA）进行了定量分析。膀胱癌患者脱落尿路上皮细胞中的端粒酶活性水平显著高于所有健康病例和良性疾病患者（p < 0.0001）。以健康病例脱落尿路上皮细胞端粒酶活性水平的平均值 + 2SD计算临界值。使用该临界值，41例膀胱癌患者脱落尿路上皮细胞中有26例端粒酶活性呈阳性（敏感性为63.4%），69例健康病例和良性疾病患者脱落尿路上皮细胞中有63例呈阴性（特异性为91.3%）。脱落细胞中端粒酶活性的敏感性高于尿细胞学检查，尤其是在低级别肿瘤中。我们的结果表明，对脱落尿路上皮细胞中端粒酶活性进行定量分析可能成为检测膀胱癌的微创且有用的方法。
