Telomerase is a highly sensitive and specific molecular marker in fine-needle aspirates of breast lesions
Telomerase is a highly sensitive and specific molecular marker in fine-needle aspirates of breast lesions
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DOI：
10.1200/jco.1999.17.7.2020
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发表时间：
1999-07-01
影响因子：
45.3
通讯作者：
Boecker, W
中科院分区：
文献类型：
--
作者：
Poremba, C;Shroyer, KR;Boecker, W
目的：在大多数人类恶性肿瘤中检测到端粒酶，使端粒酶活性（TA）成为人类与不朽细胞之间的一个关键区别。在这项研究中，我们采用盲法评估了TA与乳腺病变细针抽吸（FNAs）细胞学和最终临床/病理诊断的关系。材料和方法：在172例FNAs中，包括80例细胞学恶性样本，18例非典型但不能诊断为恶性肿瘤的样本，74例细胞学良性样本，TA通过改进的非放射性端粒重复扩增协议（TRAP）测定。最终诊断是通过对所有细胞学上的恶性样本、大部分细胞学上的非典型样本和一部分细胞学上的良性样本的随访手术材料的病理检查做出的。结果：172份样品中有85份检测到TA。细胞学和组织学诊断与TA的比较显示，87例乳腺癌患者的样本中有80例端粒酶阳性，灵敏度为92%，5例细胞学不典型但不能诊断为恶性肿瘤的FNAs中有4例发现TA。85例乳腺良性病变80例端粒酶阴性，特异性为94%，本组5例阳性均为低TA的纤维腺瘤，18例细胞学诊断为异型的患者中，TRAP结果与组织学诊断有很强的正相关。结论：在乳腺病变的FNAs中检测TA是一种高度敏感和特异性的恶性肿瘤标志物，可以作为细胞学诊断模棱两可的病例的辅助手段，(C) 1999年由美国临床肿瘤学会（American Society of Clinical Oncology）提出。
Purpose: Telomerase has been detected in a majority of human malignant tumors, making telomerase activity (TA) one key difference between mortal and immortal cells. In this study, we evaluated in blind-trial fashion the association of TA with cytologic and final clinical/pathologic diagnosis in fine-needle aspirates (FNAs) of breast lesions,Materials and Methods: In 172 FNAs, including 80 samples that were cytologically malignant, 18 that were atypical but not diagnostic for malignancy, and 74 that were cytologically benign, TA was determined by a modified nonradioactive telomeric repeat amplification protocol (TRAP) assay. Final diagnosis was made by pathologic examination of follow-up surgical material available for all the cytologically malignant samples, a majority of the cytologically atypical samples, and a portion of the cytologically benign samples.Results: TA was detected in 85 of 172 samples. Comparison of the cytologic and histologic diagnoses with TA showed that 80 of 87 samples from patients with breast cancer were telomerase-positive, resulting in a sensitivity of 92%, TA was found in four of five FNAs from carcinomas that were considered cytologically atypical but not diagnostic for malignancy. Eighty of 85 samples from patients with benign breast lesions were telomerase-negative, revealing a specificity of 94%, The five positive cases in this group were all fibroadenomas with low TA, Among the 18 cases with a cytologic diagnosis of atypia, there was a strong positive relationship between TRAP findings and histologic diagnosis.Conclusion: The detection of TA in FNAs of breast lesions is a highly sensitive and specific marker of malignancy and may be used as an adjunct in cases with an equivocal cytologic diagnosis, (C) 1999 by American Society of Clinical Oncology.