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目的探讨人端粒酶RNA(hTR)、人端粒酶逆转录酶(hTERT)基因在神经母细胞瘤自然逆转成熟及恶性增殖中的表达及其意义。方法应用原位杂交方法检测34例神经母细胞瘤、5例神经节神经母细胞瘤、8例神经节细胞瘤、16例胎儿肾上腺髓质、20例新生儿肾上腺髓质中hTR、hTERT基因的表达。结果hTR、hTERT基因在病理分型F型中的阳性表达均为46.15%(6/13);UF型中阳性表达分别是85.71%(18/21)、90.48%(19/21);两组比较差异有显著性意义(χ2=6.05,P<0.05;χ2=8.10,P<0.05)。在神经节神经母细胞瘤中hTR、hTERT基因的阳性表达均为20%。神经节细胞瘤中hTR、hTERT基因的阳性表达分别是25%、12.5%;二组与神经母细胞瘤比较差异有显著性意义(χ2=11.70,P<0.05;χ2=10.81,P<0.05)。在胎儿及新生儿肾上腺髓质中hTR、hTERT基因为弱阳性及阴性。结论在神经母细胞自然逆转成熟及恶性增殖是时hTR、hTERT起了重要的作用,当hTR、hTERT基因表达减弱,神经母细胞具有自然逆转成熟的趋势,当hTR、hTERT基因表达阳性,提示神经母细胞增殖力增强,因此hTR、hTERT基因的表达可作临床判断预后的指标。
Objective To investigate the expression and significance of human telomerase RNA (hTR) and human telomerase reverse transcriptase (hTERT) genes in the natural maturation and malignant proliferation of neuroblastoma. Methods 34 cases of neuroblastoma, 5 cases of ganglioneuroblastoma, 8 cases of ganglioneuroma, 16 cases of fetal adrenomedullin and 20 cases of adrenal medulla of newborn were detected by in situ hybridization. expression. Results The positive rates of hTR and hTERT in pathological F were 46.15% (6/13) respectively. The positive rates of hTERT in UF were 85.71% (18/21) and 90.48% (19/21) The difference was significant (χ2 = 6.05, P <0.05; χ2 = 8.10, P <0.05). In ganglion neuroblastoma hTR, the positive expression of hTERT gene was 20%. The positive rates of hTR and hTERT in gangliocytoma were 25% and 12.5%, respectively. There was significant difference between the two groups (p <0.05) . In fetal and neonatal adrenal medulla hTR, hTERT gene is weakly positive and negative. Conclusions hTR and hTERT play an important role in the natural reversal of mature and malignant proliferation of neuroblasts. When the expression of hTR and hTERT is weakened, the neuroblasts tend to naturally reverse and mature. When the expression of hTR and hTERT is positive, it suggests that the neural Therefore, the expression of hTR and hTERT gene can be used as an index to judge the clinical prognosis.