CAJ | 학술논문

目的探讨端粒酶作为肺癌肿瘤标记物的可能性，评价端粒酶活性对肺癌的早期诊断价值。方法采用改良银染－端粒重复序列扩增法（TRAP）检测40例原发性支气管肺癌手术标本及40例CT扫描疑诊为肺癌患者的纤维支气管镜活检标本的端粒酶活性。结果两组中小细胞肺癌端粒酶阳性率均为100％，非小细胞肺癌分别为84.8％、95.7％。40例手术切除肺癌组织的端粒酶阳性率为87.5％(35／40)，癌旁肺组织为7.5％(3／40)，正常肺组织无表达(0／40)，三组间比较有显著性差异(P＜0.01)。40例CT扫描疑诊为肺癌患者的纤维支气管镜肺活检标本的端粒酶阳性率为82.5％，肺癌检出的敏感度为96.4％，特异度为71.4％，准确性为91.4％；尤登指数（Youden's Index）J＝0.678，SE（J）＝0.174。结论端粒酶是灵敏的肺癌肿瘤标记物，对纤维支气管镜活检标本行端粒酶活性检测有助于肺癌的早期诊断。
목적탐토단립매작위폐암종류표기물적가능성，평개단립매활성대폐암적조기진단개치。방법채용개량은염－단립중복서렬확증법（TRAP）검측40례원발성지기관폐암수술표본급40례CT소묘의진위폐암환자적섬유지기관경활검표본적단립매활성。결과량조중소세포폐암단립매양성솔균위100％，비소세포폐암분별위84.8％、95.7％。40례수술절제폐암조직적단립매양성솔위87.5％(35／40)，암방폐조직위7.5％(3／40)，정상폐조직무표체(0／40)，삼조간비교유현저성차이(P＜0.01)。40례CT소묘의진위폐암환자적섬유지기관경폐활검표본적단립매양성솔위82.5％，폐암검출적민감도위96.4％，특이도위71.4％，준학성위91.4％；우등지수（Youden's Index）J＝0.678，SE（J）＝0.174。결론단립매시령민적폐암종류표기물，대섬유지기관경활검표본행단립매활성검측유조우폐암적조기진단。
Objective　To explore the possibility of telomerase as tumor marker of lung cancer and to evaluate its value on early diagnosis of lung cancer. Methods　Telomerase activity was measured in 40 resected specimens of lung cancer and 40 preoperative fibro-optic bronchoscope biopsied specimens of suspected lung cancer by PCR based silver staining telomeric repeat amplification protocal (TRAP) respectively. Results　The positive rate of telomerase was 100％ in SCLC, but 84.8％ in resected samples and 95.7％ in biopsied samples in NSCLC. The positive rate of telomerase was 87.5％(35／40) in resected lung cancer tissues, 7.5％(3／40) in paracancerous tissues and 0％(0／40) in normal lung tissues (P＜0.01). 82.5％ (34／40) biopsied specimens of suspected lung cancer were detected with telomerase activity. Its sensitivity, specificity， and accurate rate was 96.4％, 71.4％, and 91.4％ respectively for detection of lung cancer, Youden’s Index (J)＝0.678，and SE（J）＝0.174. Conclusion　Telomerase may be a sensitive tumor marker of lung cancer. Detecting telomerase activity in preoperative fibro-optic bronchoscope biopsied specimens may contribute to early diagnosis of lung cancer.