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World J Gastroenterol. Jun 14, 2007; 13(22): 3122-3127
Published online Jun 14, 2007. doi: 10.3748/wjg.v13.i22.3122
Clinical significance of telomerase activity in peritoneal lavage fluid from patients with gastric cancer and its relationship with cellular proliferation
Ming-Xu Da, Xiao-Ting Wu, Tian-Kang Guo, Zi-Guang Zhao, Ting Luo, Kun Qian, Ming-Ming Zhang, Jie Wang
Ming-Xu Da, Jie Wang, Department of General Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
Xiao-Ting Wu, Zi-Guang Zhao, Ting Luo, Kun Qian, Ming-Ming Zhang, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Tian-Kang Guo, Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Author contributions: All authors contributed equally to the work.
Supported by the National Natural Science Foundation of China, No. 30370639
Correspondence to: Jie Wang, Department of General Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou 510120, Guangdong Province, China. jyfydmx@yahoo.com.cn
Telephone: +86-13682278269 Fax: +86-20-87334115
Received: March 15, 2007
Revised: April 1, 2007
Accepted: April 9, 2007
Published online: June 14, 2007
Abstract

AIM: 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 pT4 (15/16 vs 9/16, P < 0.05), P1-3 (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).

CONCLUSION: 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.

Keywords: Gastric cancer; Telomerase activity; Peritoneal lavage cytology; Peritoneal metastasis; Proliferating cell nuclear antigen