Clinical significance of telomerase activity in peritoneal lavage fluid from patients with gastric cancer and its relationship with cellular proliferation.
OBJECTIVE
To evaluate the efficacy of telomerase activity assay and peritoneal lavage cytology (PLC) examination in peritoneal lavage fluid for the prediction of peritoneal metastasis in gastric cancer patients, and to explore the relationship between telomerase activity and proliferating cell nuclear antigen expression.


METHODS
Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity in 60 patients with gastric cancer and 50 with peptic ulcer. PLC analysis of the 60 patients with gastric cancer was used for comparison. The proliferating cell nuclear antigen (PCNA) in gastric carcinoma was immunohistochemically examined.


RESULTS
The telomerase activity and PLC positive rate in peritoneal lavage fluid from patients with gastric cancer was 41.7% (25/60), and 25.0% (15/60), respectively. The positive rate of telomerase activity was significantly higher than that of PLC in the group of pT(4) (15/16 vs 9/16, P < 0.05), P(1-3) (13/13 vs 9/13, P < 0.05) and diffuse type (22/42 vs 13/42, P < 0.05). The patients with positive telomerase activity, peritoneal metastasis, and serosal invasion had significantly higher levels of average PCNA proliferation index (PI), (55.00 +/- 6.59 vs 27.43 +/- 7.72, 57.26 +/- 10.18 vs 29.15 +/- 8.31, and 49.82 +/- 6.74 vs 24.65 +/- 7.33, respectively, P < 0.05).


CONCLUSIONS
The TRAP assay for telomerase activity is a useful adjunct for cytologic method in the diagnosis of peritoneal micrometastasis and well related to higher proliferating activity of gastric cancer. The results of this study also suggest a promising future therapeutic strategy for treating peritoneal dissemination based on telomerase inhibition.
Da
Ming-Xu
MX
Department of General Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China.
Wu
Xiao-Ting
XT
Guo
Tian-Kang
TK
Zhao
Zi-Guang
ZG
Luo
Ting
T
Qian
Kun
K
Zhang
Ming-Ming
MM
Wang
Jie
J
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000201:enzymology / Q000556:secondary; D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000201:enzymology; D014408:Biomarkers, Tumor / Q000378:metabolism; D049109:Cell Proliferation; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D021141:Nucleic Acid Amplification Techniques; D010437:Peptic Ulcer / Q000201:enzymology; D010533:Peritoneal Lavage / Q000379:methods; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000556:secondary; D011237:Predictive Value of Tests; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D013274:Stomach Neoplasms / Q000201:enzymology / Q000473:pathology*; D019098:Telomerase / Q000032:analysis / Q000378:metabolism*
D014408:Biomarkers, Tumor; D018809:Proliferating Cell Nuclear Antigen; D019098:Telomerase