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頁籤選單縮合
題 名 | Telomerase Activity in Human Bladder Tumors and Bladder Washing Specimens=膀胱癌及膀胱沖洗液的端粒酵素活性 |
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作 者 | 吳文正; 劉立德; 黃俊雄; 張瑞烽; 張玲麗; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 17:12 2001.12[民90.12] |
頁 次 | 頁602-609 |
分類號 | 415.837 |
關鍵詞 | 膀胱癌; 膀胱沖洗液; 端粒酵素活性; Bladder cancer; Telomerase; Bladder washing; Cytology; |
語 文 | 英文(English) |
中文摘要 | 端粒酵素在調控細胞增殖與癌化扮演重要角色。在大多數的人類腫瘤, 此酵素活性均明顯增加。本研究將評估端粒酵素活性做為臨床指標應用,在膀胱 癌診斷與追蹤病情的角色。以端粒酵素連續增幅-酵素免疫分析 (PCR-ELISA) 方 法,共分析了77例膀胱癌組織檢體,21例癌周圍正常組織與37例膀胱沖洗液 檢體。結果顯示:87% (67/77)的膀胱癌組織與38% (8/21)癌周圍正常組織的端粒 酵素為陽性反應。不過,膀胱癌組織端粒酵素活性明顯高於癌周圍正常組織的酵 素活性 (p<0.05)。但膀胱癌的端粒酵素活性陽性與否和腫瘤的分期與細胞分化度 皆無關。在26個月的追蹤期間,有66.7% (4/6)的癌周圍正常組織端粒酵素為陽 性反應的侵犯性癌患者發生癌病復發轉移情形。但在癌周圍正常組織端粒酵素為 陰性反應的侵犯性癌患者,只有14.3% (1/7)有癌病復發轉移情形。二者間在預後 差異上,有統計上趨向不同的現象。以膀胱沖洗液剝落細胞的端粒酵素活性測定 與其原發膀胱癌組織端粒酵素活性相比較,端粒酵素活性測定的陽性偵測的敏感 度達81%,特異度有75%。但是,若以沖洗液剝落細胞的細胞學診斷則只有31% 的陽性偵測率。本研究的結論是:在早期的膀胱癌發生上,端粒酵素即被活化。 它或許可以作為膀胱癌的分子層次上的檢查指標。而癌周圍正常組織的端粒酵素 活性陽性,可能在侵犯性癌患者是一個預後不良的指標。利用膀胱沖洗液剝落細 胞的端粒酵素活性測定分析,可以輔助尿液細胞學及膀胱鏡檢查,提高膀胱癌的 診斷與病情追蹤能力。 |
英文摘要 | Telomerase appears to be an important factor for the control of cellular proliferation and tumorigenesis. Enzyme activity dramatically increases in almost all human tumors. The purpose of our study was to evaluate the role of telomerase activity as a marker for bladder cancer diagnosis and follow-up. By using the PCR-ELISA based on the TRAP (telomerase repeat amplification protocol) method, telomerase activity of bladder tumors (n=77), normal-appearing adjacent tissues (n=21) and bladder washings (n=37) were analyzed. Telomerase activity was detected in 87% (67/77) of cancer tissues and in 38% (8/21) of normal-appearing adjacent tissues. However, the levels of enzyme activity were significantly higher in cancer tissues than in normal-appearing adjacent tissues (p<0.05). Telomerase activity in bladder cancer tissues was not correlated to the tumor stage or grade. During a 26 months follow-up period, disease progression occurred in 66.7% of patients with invasive tumors where telomerase activity of the normal-appearing adjacent tissue was detectable, as compared to only 14.3% for patients who showed undetectable telomerase activity in adjacent, normal-appearing tissues (p=0.094). When telomerase activity of bladder washing fluid was compared with its corresponding tumors, sensitivity of detection was 81% and specificity was 75%. In contrast, urine cytology only yielded a sensitivity of 31% in the detection of cancer. The detection ability between telomerase activity measurement in washing fluid and cytological examination had a trend toward the telomerase measurement identifying more cancer cases than the cytologic examination (p= 0.07). In conclusion, telomerase activity is present in early-stage bladder cancer and is a potential molecular marker for bladder tumors diagnosis. The expression of telomerase activity in normal-appearing mucosa adjacent to bladder tumor is probably an indicator of disease progression. Using the telomerase activity to detect exfoliated cells in bladder washing fluids could be a useful method in adjunct to urine cytology and cystoscopy in establishing the diagnosis and follow-up of bladder cancer. |
本系統中英文摘要資訊取自各篇刊載內容。