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目的探讨端粒酶hTERTmRNA表达在人乳腺癌发生、发展中的意义,观察肿瘤抑制基因p53与hTERTmRNA表达的关系。方法收集浸润性导管癌标本25例,导管原位癌标本18例,导管上皮不典型增生标本20例,导管上皮单纯性增生标本7例,癌旁正常乳腺组织标本12例。用原位杂交法检测hTERTmRNA表达,并用免疫组化方法检测乳腺导管癌的p53蛋白表达。结果hTERTmRNA在癌旁正常乳腺组织、乳腺导管单纯性增生中未见表达;在导管不典型增生、导管原位癌、浸润性导管癌中的阳性率分别为25.0%、83.3%和88.0%。导管原位癌、浸润性导管癌组织hTERTmRNA表达明显高于癌旁正常乳腺组织、乳腺导管单纯性增生和导管不典型增生组织(P<0.05)。hTERTmRNA表达与浸润性导管癌肿块大小及淋巴结转移与否无关(P>0.05)。43例乳腺导管癌中,hTERTmRNA表达与p53蛋白表达呈正相关(r=0.5540,P<0.01)。结论端粒酶hTERT mRNA表达可能在乳腺导管癌的组织发生中起关键作用,半定量原位检测hTERTmRNA表达,可为导管上皮不典型增生与导管原位癌的鉴别诊断提供帮助。p53突变可能与乳腺导管癌hTERT基因转录激活有关。
Objective To investigate the significance of telomerase hTERT mRNA expression in the development and progression of human breast cancer and to observe the relationship between the expression of tumor suppressor gene p53 and hTERT mRNA. Methods Twenty - five cases of invasive ductal carcinoma, 18 cases of ductal carcinoma in situ, 20 cases of atypical ductal hyperplasia, 7 cases of ductal hyperplasia and 12 cases of normal breast tissue were collected. The expression of hTERT mRNA was detected by in situ hybridization and the expression of p53 protein was detected by immunohistochemistry. Results The expression of hTERT mRNA was not found in the adjacent normal breast tissue and ductal hyperplasia. The positive rates of hTERT mRNA in ductal dysplasia, ductal carcinoma in situ and invasive ductal carcinoma were 25.0%, 83.3% and 88.0% respectively. The expression of hTERT mRNA in ductal carcinoma in situ and invasive ductal carcinoma tissues was significantly higher than that in adjacent normal breast tissue, ductal hyperplasia and atypical ductal hyperplasia (P <0.05). The expression of hTERT mRNA was not associated with the size of the tumor and the lymph node metastasis (P> 0.05). 43 cases of breast ductal carcinoma, hTERTmRNA expression and p53 protein expression was positively correlated (r = 0.5540, P <0.01). Conclusion Telomerase hTERT mRNA expression may play a key role in the carcinogenesis of breast ductal carcinoma. Semi-quantitative in situ detection of hTERT mRNA expression may be helpful in the differential diagnosis of ductal dysplasia and ductal carcinoma in situ. p53 mutation may be related to the transcriptional activation of hTERT gene in breast ductal carcinoma.