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目的:探讨端粒酶逆转录酶(human telomeras ereverset ranscrip tase,hTERT)在肺癌癌前病变(支气管黏膜上皮不典型增生)和肺癌中的作用。方法:41例支气管黏膜上皮不典型增生患者经纤维支气管镜取气管上皮组织、150例肺癌患者手术标本及40例正常肺组织,用免疫组化的方法检测hTERT基因在上述肺组织中的表达。结果:5·0%(2/40)的正常肺组织中可检测到hTERT基因的蛋白表达,61·0%(25/41)的支气管黏膜上皮不典型增生组织和90·0%(135/150)的肺癌组织中可检出hTERT基因表达,组间差异有高度显著性,χ2=111·9,P<0·01;且随着肺组织癌变过程的变化,hTERT基因的表达呈逐渐增高的趋势,χt2rend=107·7,P<0·01。结论:支气管黏膜上皮细胞的不典型增生和恶性转化与hTERT基因的表达有关;hTERT基因检测有望成为诊断肺癌变的早期生物标志物。
Objective: To investigate the role of human telomerase reverse transcriptase (hTERT) in precancerous lesions of the lung (bronchial epithelial dysplasia) and lung cancer. METHODS: Twenty-one patients with atypical hyperplasia of bronchial mucosa were examined by bronchofibroscopy for bronchial epithelial tissue, 150 cases of lung cancer and 40 cases of normal lung tissue. The expression of hTERT gene in the lung tissue was detected by immunohistochemistry. Results: The expression of hTERT gene was detected in normal lung tissue of 5% (2/40), bronchial epithelial atypical hyperplasia in 60.0% (25/41) and 90.0% (135 / 150), hTERT gene expression was detected in the lung cancer tissues. The difference between the two groups was highly significant (χ2 = 111.9, P <0.01). The expression of hTERT gene was gradually increased with the progression of lung cancer Trend, χt2rend = 107 · 7, P <0.01. CONCLUSION: Atypical hyperplasia and malignant transformation of bronchial mucosa epithelial cells are associated with the expression of hTERT gene; hTERT gene detection is expected to become an early biomarker for the diagnosis of lung cancer.