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目的 探讨非小细胞肺癌 (non smallcelllungcancer ,NSCLC)端粒酶活性 (telomeraseactivity ,TA)、端粒酶RNA(telomeraseRNA ,hTR)、端粒酶催化亚单位 (telomerasecatalyticsubunit,hTRT/hEST2 )编码基因的表达 ,彼此间相关性及其预后意义。方法 TRAP PCR(telomeraserepeatamplificationprotocolPCR)检测TA ,RT PCR检测hTR ,原位杂交检测hTRT/hEST2 mRNA表达。结果 非小细胞肺癌TA、hTR和hTRT/hEST2 mRNA阳性率分别为 6 8.4% (2 6 / 38)、5 5 .2 % (32 / 5 8)和 74.1% (4 3/ 5 8) ,TA与hTRT/hEST2 阳性相关 (r=0 .84,P =0 .0 1) ,与hTR无相关性 (r=0 .16 ,P =0 .2 3)。低分化以及有淋巴结或远处转移者TA及hTRT/hEST2 阳性率增高 ;TA及hTRT/hEST2 阳性组中位生存期 (10 .4个月 ,7.5个月 )低于阴性组 (13.5个月 ,14.7个月 ;P =0 .0 74,P =0 .0 1) ,hTR阳性组中位生存期 (12 .9个月 )略高于阴性组 (11.5个月 ,P =0 .2 3) ,仅hTRT/hEST2 阳性与阴性组生存期差异有显著性 ;多因素Cox回归分析hTRT/hEST2 对生存期有影响。结论 非小细胞肺癌TA、hTR和hTRT/hEST2 表达高于癌旁正常组织 ;hTRT/hEST2 够能反应TA活性 ,二者为NSCLC恶性表型增高的标志 ;hTRT/hEST2 具有独立的预后意义。
Objective To investigate the expression of telomerase activity (TA), telomerase RNA (hTR) and telomerase catalytic subunit (hTRT/hEST2) genes in non-small cell lung cancer (NSCLC). Correlations and their prognostic significance. Methods TA was detected by TRAP PCR (telomerase polymerase PCR), RT-PCR was used to detect hTR, and in situ hybridization was used to detect hTRT/hEST2 mRNA expression. Results The positive rates of TA, hTR and hTRT/hEST2 mRNA in NSCLC were 6 8.4% (2 6 / 38), 55.2% (32 / 5 8) and 74.1% (4 3 / 5 8), respectively. Correlation with hTRT/hEST2 positive (r=0.84, P=0.O1) was not associated with hTR (r=0.16, P=0.23). The positive rates of TA and hTRT/hEST2 were higher in poorly differentiated and lymph nodes or distant metastases; the median survival time in TA and hTRT/hEST2 positive groups (10 .4 months, 7.5 months) was lower than that in negative groups (13.5 months, 14.7 months; P =0.0 74, P =0. 0 1), the median survival of the hTR-positive group (12. 9 months) was slightly higher than that of the negative group (11.5 months, P =0.23) There was a significant difference in survival between hTRT/hEST2 positive and negative groups. Multivariate Cox regression analysis of hTRT/hEST2 had an effect on survival. Conclusions The expression of TA, hTR and hTRT/hEST2 in non-small cell lung cancer is higher than that in adjacent normal tissues; hTRT/hEST2 is sufficient to reflect TA activity, both of which are markers of increased malignant phenotype of NSCLC; hTRT/hEST2 has independent prognostic significance.