The Guidance Of Telomerase Activity And Human Telomerase Reverse Transcriptase MRNA Expression And Image Examination On The Diagnosis And Treatment Of Orbital Tumor

OBJECTIVE: To study the correlation of diagnosis with telomerase activity and hTERT mRNA expression in orbital tumor. To investigate the relationship between telomerase activity and hTERT mRNA expression in orbital tumor to determine whether detection of hTERT mRNA expression can be used as an alternative method for telomerase activity. To determine the characteristic of orbital tumor on ultrasonography,computer tomography and magnetic resonance imagine.To make an indications and operative skill for common orbitotomy,with the guidance of Image Examinations.METHODS: Telomerase activity was examined by TRAP-silver stained assay in 70 orbital samples resected surgically, including 20 malignant tumor tissues, 20 adjacent non-tumor orbital tissues at 1-cm distance from tumor, 40 benign tumor tissues, 5 inflammatory pseudotumor tissues and 5 normal orbital tissues. Expression of hTERT mRNA was also assessed by RT-PCR in all orbital tissues. The relationship between telomerase activity and hTERT mRNA expression were analyzed in all patients. Image examination including B-ultrasound, Computed tomography and Magnetic resonance imaging and surgical procedures were analyzed in 305 cases of orbital diseases from 2000 to 2004.RESULTS: In 70 surgical orbital samples, the positivity of telomerase activity in malignant tumor tissues, adjacent non-tumor orbital tissues, benign tumor tissuesresected surgically was 90% (18/20), 15% (3/20), 2.5% (1/40) respectively. Telomerase activity was not detected in 5 inflammatory pseudotumor tissues and normal liver tissues.In 70 surgical orbital samples, The positive incidence of hTERT mRNA expression in malignant tumor tissues, adjacent non-tumor orbital tissues, benign tumor tissues was85%(17/20)> 15%(3/20)& 2.5% (1/40) respectively. Expression of hTERT mRNA was not detected in 5 inflammatory pseudotumor tissues and normal orbital tissues. A significant correlation between telomerase activity and hTERT mRNA expression was observed in orbital tissues and adjacent non-tumor orbital tissues.Among the cases hemangioma accounts for 276 cases, neurogrnic tumor 75 cases, lacrimal tumor 70 cases, inflammatory psedotumor 35 cases, primary malignant tumor 27 cases, thyroid-associated ophthalmopathy 105 cases,carotid cavernous fistula 45 cases, painful ophthalmoplegia 2 cases.523 cases of orbitotomiy were analysed which included anterior orbitotomy 254 cases,lateral orbitotomy 251 cases,media orbitotomy 9 cases,exexterations 4 cases,orbital decompression 5 cases.CONCLUSIONS: These results indicate that detection of telomerase activity can be a useful adjuvant tool for diagnosis and differential diagnosis of orbital tumor. There is significant correlation between the level of hTERT mRNA expression and that of telomerase activity in orbital tissues. Detection of hTERT mRNA expression may be used as an alternative method for telomerase activity. The correct location diagnosis and analysis of orbital diseases can be acquired through the combined examinations of B-ultrasound, CT and MRI, which can guide the correct selection of treatment. With guidance of Image Examinations,the choice and approach depends on nature ,extension,location.The surgical approach is followed by adequate exposure,visualiation and excellent cosmetic.