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目的 :了解颅内肿瘤组织、瘤周脑组织和脑脊液中端粒酶活性的表达情况 ,探讨其临床意义。方法 :选 4 6例颅内肿瘤病人 (恶性 2 3例 ,良性 2 3例 ) ,术中取肿瘤组织和瘤周组织 ,术前 1～ 3d和术后 3～ 5d腰穿取脑脊液 (CSF) ,应用PCR -TRAP法检测其端粒酶活性 ,以 χ2 检验统计分析。结果 :恶性肿瘤组瘤组织端粒酶活性的阳性率为 95 .6 % (2 1/ 2 3) ,瘤周组织为 2 1.7% (5 / 2 3) ,术前CSF为 6 2 .5 % (10 / 16 ) ,术后CSF为 4 0 %(2 / 5 ) ;良性肿瘤组瘤组织端粒酶活性的阳性率为 6 5 % (15 / 2 3) ,瘤周组织为 2 1.7% (5 / 2 3) ,术前CSF为37.5 % (6 / 16 ) ,术后CSF为 0 (0 / 5 ) ;肿瘤全切后脑脊液端粒酶活性阳转阴率 87.5 % (7/ 8) ;恶性肿瘤瘤组织中端粒酶活性的阳性率明显高于良性肿瘤 (χ2 =4 .6 ,P <0 .0 5 )。结论 :颅内良性肿瘤和恶性肿瘤均有端粒酶活性的表达 ,其表达率后者明显高于前者 ;术前脑脊液中端粒酶活性的检测可用于脑肿瘤的临床诊断和鉴别诊断 ;瘤周组织和术前脑脊液中端粒酶活性的检测 ,尤其是术前术后CSF中端粒酶活性阳转阴有望成为评估肿瘤复发的指标。
Objective: To investigate the expression of telomerase activity in intracranial tumor, peritumor brain tissue and cerebrospinal fluid (CSF), and to explore its clinical significance. Methods: Forty-six patients with intracranial tumors (23 cases of malignant and 23 cases of benign) were selected. Tumor tissues and peritumoral tissues were collected during operation. Cerebrospinal fluid (CSF) was obtained by lumbar puncture 1 to 3 days before operation and 3 to 5 days after operation. , And its telomerase activity was detected by PCR-TRAP. Statistical analysis was performed by χ2 test. Results: The positive rate of telomerase activity was 95.6% (21/23) in tumor tissue and 21.7% (5/23) in tumor tissue, respectively. The preoperative CSF was 62.5% (10/16) and postoperative CSF was 40% (2/5). The positive rate of telomerase activity in benign tumor was 65% (15/2) and that in peritumoral tissue was 21.7% (2/5) CSF was 37.5% (6/16) and postoperative CSF was 0 (0/5). The positive rate of positive telomerase activity in cerebrospinal fluid was 87.5% (7/8) after complete resection of tumor. The positive rate of telomerase activity in malignant tumor was significantly higher than that in benign tumor (χ2 = 4.6, P <0.05). Conclusion: The expression of telomerase activity in both benign tumors and malignant tumors is higher than that in the former. The detection of telomerase activity in cerebrospinal fluid can be used in clinical diagnosis and differential diagnosis of brain tumors. Detection of telomerase activity in cerebrospinal fluid and in preoperative cerebrospinal fluid, especially in patients with preoperative and postoperative CSF telomerase activity, is expected to be an indicator of tumor recurrence.