Study On The Diagnostic Value Of Telomerase Activity And HTERT In Pleural Effusions

Objectives:To determine the activity of telomerase in lymphocytes,which were separated from pleural fluid and investigate its effect on the overall activity in pleural effusions,which can be used to assess the diagnostic value of telomerase activity in differentiating malignant pleural effusion from benign ones. In addition,the present study was to explore the relationship between activity and hTERT expression and to evaluate its diagnostic significance in pleural effusions. Methods:According to the final diagnosis achieved,51 patients were classified into two groups such as malignant group (27 patients) and benign group (24 patients). Lymphocytes were obtained from pleural fluid by density gradient centrifugation assay,Then TA were performed by TRAP-ELISA in lymphocytes samples and control ones of the same group,respectively. hTERT was detected by Western blotting assay. In the end,the following data such as sensitivity,specificity,positive predictive value,negative predictive value and accuracy of telomerase activity are available and compared with CEA results. Differences of results are evaluated by t test and chi-square test. Results:1. Cells separation:in the group of malignant pleural effusions,23 lymphocytes and 6 tumor cells of 27 samples were separated,while 18 lymphocytes were separated from 24 samples in benign group. 2. TA assay:in malignant group,24 of 27 samples were found to possess telomerase activity,while 1 of 23 lymphocytes samples were positive with enzyme activity. All 6 samples of tumor cells were also positive. In 51 pleural effusions,sensitivity,specificity,positive predictive value,negative predictive value and accuracy of TA test was 88.9%,95.8%,96%,88.5%,92.2%,respectively. There is significant difference between malignant and benign groups (PO.01),while TA of lymphocytes has no effect on overall results (P>0.01). There is also a higher effect than that of CEA. 3. hTERT test:in malignant group,8 of 27 samples were positive bywestern blotting assay,while none of 12 benign samples was positive. To some extent,there is relationship between TA and hTERT. Conclusions:1. It is demonstrated that TRAP-ELISA is better than CEA on positive rate of test. TA of lymphocytes has not effect on overall results in pleural effusions. In conclusion,TRAP-ELISA may be a diagnostic adjunct in cytopathology for malignant pleural effusions and substitute the CEA test. 2. The results indicate that positive results of hTERT test have finally diagnostic value for malignant pleural effusions,but it is unsuitable for routine diagnosis due to the higher demands of techniques.