涎腺肿瘤细针吸取标本端粒酶活性检测及其临床意义  

DETECTION OF TELOMERASE ACTIVITY AND ITS SIGNIFICANCE IN SALIVAR GLAND TUMOR FRAE-NEEDLE ASPIRATING SPECIMENS

作　　者：陈良建[1] 李赞[2] 黄建华[1] 颜学德[1] 胡荣桂[2] 陈正炎[3] 

机构地区：[1]中南大学湘雅三医院口腔科,长沙410013 [2]湖南省肿瘤医院 [3]中南大学湘雅医学院检验系

出　　处：《中国现代医学杂志》2003年第15期55-57,60,共4页China Journal of Modern Medicine

摘　　要：目的 :检测涎腺肿瘤细针吸取标本的端粒酶活性并探讨其在涎腺肿瘤诊断中的价值。方法 :采用细针穿刺技术穿刺手术切除新鲜的 6 5例涎腺肿块组织 ,取FNA标本涂片 ,苏木精 -曙红 (HE)染色 ,作细胞学检查 ;残留于注射器内细胞用PBS液冲洗离心后 ,取沉淀物用银染 -TRAP法检测其端粒酶活性 ;肿块组织作病理学检查。结果 :17例FNA标本涎腺肿块细胞学检查诊断为恶性肿瘤 ,其中 14例 (82 % )端粒酶活性检测为阳性。 13例细胞学检查为不典型或不能确诊 ,有 7例端粒酶活性检测为阳性 ,随后组织病理诊断为恶性肿瘤 ,而 6例端粒酶活性检测为阴性标本有 5例最后组织病理诊断为良性肿块。 35例细胞学诊断为良性或取材不满意的FNA标本 ,有 4例端粒酶活性检测阳性而病理学检查有 2例为恶性肿瘤。结论 :FNA标本端粒酶检测诊断效率 (89.2 % )优于细胞学检查 (6 6 .2 % ) (U =3.15 >2 .5 8,P <0 .0 1) ,端粒酶活性检测是对FNA细胞学检查存在假阴性的补充检查并可作为涎腺恶性肿瘤诊断指标 ,特别是细胞学检查不能确诊的恶性肿瘤FNA标本。Objective:To investigate the telomerase activity in salivary gland trmor frae-needle aspirating (FNA) specimens and to explore its diagnostic value in salivary gland tumor.Methods:Sixty-five FNA specimens were obtained from fresh salivary tumor tissues after surgical excision. FNA specimens were smeared on glass slides and stained by the hematoxylin and eosin(H&E) method, Slide preparation and cytology were performed. Extracts from the residual cells in the syringe were used for the silver-staining telomeric repeat amplification protocol (TRAP)assay. Sixty-five samples were diagnosed by histopathologic examination.Results:All 17 tumors that were diagnosed as 'malignant'or 'probably maligant'by FNA cytology were cancerous, and 14 cases (82%)showed detectable telomerase activity. Among 13 'atypical' or 'indeterminate' cases, all 7 tumors with detectable telomerase activity subsequently were diagnosed as salivary gland carcinoma whereas 5 of 6 tumors without telomerase activity were diagnosed as benign. Among the 35 'benign'or 'unsatisfactory' samples,2 of 4 cases with detectable telomerase activity subsequently were diagnosed as cancer.Conclusions:The diagnostic efficiency of telomerase activity in FNA specimens is superior to that of cytology (89.2% vs 66.2% ) (U=3.15>2.58, P <0.01 ) .Detection of telomerase activity should be considered as an alert for false-negative results of FNA cytology and may be useful as a diagnostic marker for salivary gland carcinoma .

关 键 词：涎腺肿瘤 细针穿刺活检 细胞学 端粒酶 端粒重复序列扩增技术 

分 类 号：R739.87[医药卫生—肿瘤]