Detection of early hilar lung cancer and bronchial dysplasia using fluorescence bronchoscopy and telomerase analysis.

在这项研究中，我们分析端粒酶活性的浸润前支气管病变活检标本获得的荧光支气管镜。我们研究了74例支气管活检标本（22例正常支气管上皮或支气管炎，15例鳞状上皮化生，23例不典型增生和14例鳞状细胞癌）通过荧光支气管镜获得。采用荧光TRAP法检测活检组织中端粒酶活性。正常支气管上皮、支气管炎、鳞状上皮化生、不典型增生和鳞癌的端粒酶活性平均值分别为6.2±7.5、13.9±14.8、18.5±20.8和54.5±22.3单位。正常支气管上皮端粒酶活性的上限为21个单位（平均值± 2SD）。有趣的是，15例鳞状上皮化生中有5例（33%），23例异型增生中有8例（35%）和所有鳞状细胞癌（100%）活检组织显示端粒酶活性水平高于21个单位。此外，发现从正常支气管上皮或支气管炎到鳞状细胞癌的组织学变化的严重程度与端粒酶活性成比例增加。这些结果表明，端粒酶活性的增加是肺鳞状细胞癌的发展的早期阶段的一个特点，与强端粒酶活性是突出的在后期阶段。

In this study, we analyze telomerase activity of preinvasive bronchial lesions using biopsy specimens obtained by fluorescence bronchoscopy. We studied 74 bronchial biopsy specimens (22 normal bronchial epithelium or bronchitis, 15 squamous metaplasia, 23 dysplasia and 14 squamous cell carcinoma) obtained by fluorescence bronchoscopy. The intensity of telomerase activity in the biopsy specimen was determined by the fluorescence-based TRAP method. The mean values (±SD) of telomerase activity in normal bronchial epithelium or bronchitis, squamous metaplasia, dysplasia and squamous cell carcinoma were 6.2±7.5, 13.9±14.8, 18.5±20.8 and 54.5±22.3 units respectively. The upper limit of telomerase activity in normal bronchial epithelium was 21 units (mean+2SD). Interestingly, 5 of 15 squamous metaplasia (33%), 8 of 23 dysplasia (35%) and all squamous cell carcinoma (100%) biopsies exhibited levels of telomerase activity higher than 21 units. In addition, telomerase activity was found to increase in proportion to the severity of histological change from normal bronchial epithelium or bronchitis to squamous cell carcinoma. These results suggest that an increase in telomerase activity is a feature of the early stages of development of squamous cell carcinoma of the lung with strong telomerase activity being prominent during the latter stages.