端粒酶基因和DNA倍体在良恶性梗阻性黄疸中的表达  

Expression of Telomerase Gene and DNA Ploidy in Obstructive Jaundice of Both Benigh and Malignant Cases

作　　者：李汛[1] 李玉民[1] 梁聚民 周文策[1] 张磊[1] 孟文勃[1] 陈昊[1] 曹农[1] 闵光涛[1] 

机构地区：[1]兰州大学第一医院普外科,兰州730000 [2]甘肃省山丹县人民医院,山丹734100

出　　处：《中国普外基础与临床杂志》2005年第4期343-345,共3页Chinese Journal of Bases and Clinics In General Surgery

基　　金：甘肃省自然科学基金资助(编号:ZS001-A23-075-Y)~~

摘　　要：目的探讨胆胰系统恶性肿瘤组织中端粒酶表达和DNA倍体的关系,以寻找一种简便、安全、快速的诊断及鉴别诊断良、恶性梗阻性黄疸的方法。方法对梗阻性黄疸病例于术前行经内镜逆行胰胆管造影(ERCP)检查,于造影前抽取胆汁或胰液、部分病例取活检组织,并于术中再次切取组织标本,对所有标本进行端粒酶表达和DNA倍体检测。结果①恶性梗阻性黄疸组织标本中端粒酶表达阳性率为87.50%(56/64),明显高于良性梗阻性黄疸组织标本中的端粒酶表达阳性率〔3.33%(2/60)〕,P=0.000。②恶性梗阻性黄疸患者胆汁或胰液中端粒酶表达阳性率为71.88%(46/64),良性梗阻性黄疸患者胆汁或胰液中端粒酶表达阳性率为3.33%(2/60),二者间差异有统计学意义(P=0.000);恶性梗阻性黄疸组内镜下钳取的活检组织,其端粒酶表达阳性率为83.33%(20/24)。③恶性梗阻性黄疸组织DNA异倍体率为62.50%(40/64),良性梗阻性黄疸组织均为二倍体,两者间差异有统计学意义(P=0.000)。④高分化肿瘤的端粒酶表达阳性率和DNA异倍体率均明显低于中、低分化者(P=0.028,P=0.001)。结论在术前通过十二指肠镜采集患者的胆汁和胰液,并钳取活检组织,分别进行端粒酶表达检测及DNA倍体检测,是一种简便、安全、快速的诊断及鉴别诊断良、恶性梗阻性黄疸的方法。Objective To explore the relation between the expression of telomerase and DNA ploidy with biliary-pancreatic system cancer, so as to find a better way to diagnose and distinguish jaundice between malignance and benign disease.Methods Endoscopic retrograde cholangiopancreatography (ERCP) were performed before operation in patients with obstructive jaundice. The bile and pancreatice juice were collected before ERCP. Biopsy specimens from part of patients were obtained during ERCP. All cancer specimens were possessed once again during operation and were assessed by the activity of telomerase and DNA ploidy. Results ① Telomerase positive rate 〔87.50% ((56/64)〕) of tissue specimens in malignant obstructive jaundice were higher than that in benign obstructive jaundice (〔3.33)%(2/60)〕,P=(0.000). ② Telomerase positive rate〔71.88% (46/64)〕of Bile and pancreatice juice in malignant obstructive jaundice were higher than that in benign obstructive jaundice 〔3.33% (2/60)〕, P=0.000, tissue specimens obtained by endoscopy with malignant obstructive jaundice had detectable telomerase activity, positive rate was 83.33%(20/24). ③ The rate of DNA heteroploid with malignant obstructive jaundice was 62.50% ((40/64)), that of diploid can be seen in all patients with benign obstructive jaundice, the difference was statistically significant (P=(0.000)). ④ The rate of telomerase positive and DNA heteroploid in high differentiation tumor were significantly lower than in middle-low differentiation tumor (P=0.028,P=0.001).Conclusion Applying the duodenoscope we collected the bile and pancreatic fluid before operation and obtain biopsy specimens whose telomerase activity and DNA ploid were detected. This is simple, safe, quick method which can identify the malignant and benign obstructive jaundice.

关 键 词：端粒酶 基因 梗阻性黄疸 DNA 

分 类 号：R657.4[医药卫生—外科学]