目的　探讨胃镜直视下刷取贲门粘膜脱落细胞中端粒酶活性及细胞学对贲门癌的诊断价值。方法　采用TRAP PCR银染定性法及TRAP PCR ELISA定量法对 72例贲门粘膜刷落细胞进行端粒酶活性分析 ,同时进行细胞学诊断及病理学诊断。结果　贲门癌组端粒酶活性 (1 5 2 1± 0 192 ,OD值 )明显高于贲门炎组 (0 0 65±0 0 14,OD值 ) ,端粒酶在贲门癌组阳性率 (88 89% )明显高于贲门炎组 (11 11% )。端粒酶在贲门癌组的阳性率明显高于贲门粘膜脱落细胞学的阳性率 (77 78% )。端粒酶联合细胞学诊断可使贲门癌的诊断率提高到93 33%。结论　贲门粘膜脱落细胞学诊断联合端粒酶活性测定可作为诊断贲门癌特异而敏感的方法 ,为贲门癌大规模普查工作奠定了基础 Objective To investigate the diagnostic value of telomerase activity and cytology in exfoliative cells of the cardia mucosa under direct gastroscopy for the diagnosis of cardiac cancer. METHODS: TRAP PCR silver staining and TRAP PCR ELISA were used to analyze the telomerase activity of 72 patients with cardiac mucosal brushing cells. Cytological diagnosis and pathological diagnosis were performed at the same time. Results The telomerase activity (1521±0192, OD value) was significantly higher in the cardia cancer group than in the cardiaphitis group (0 0 65±0 0 14 OD), and the positive rate of telomerase in the cardia cancer group (88%). 89%) was significantly higher than the cardia-inflammatory group (11 11%). The positive rate of telomerase in the cardia cancer group was significantly higher than that of the gastric cardia exfoliative cytology (77 78%). Telomerase combined with cytologic diagnosis can increase the diagnostic rate of cardiac cancer to 93 33%. Conclusion The diagnosis of gastric cardia exfoliative cytology combined with telomerase activity assay can be used as a specific and sensitive method for the diagnosis of cardiac cancer, which lays the foundation for large-scale screening of cardiac cancer.