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Pneumologie 2000; 54(11): 480-485
DOI: 10.1055/s-2000-8252
ORIGINALARBEIT
© Georg Thieme Verlag Stuttgart · New York

Telomeraseaktivität beim Bronchialkarzinom[1] [2]

Der Nachweis des „Unsterblichkeitsenzyms” in Bürstenbiopsien erhöht die diagnostische Ausbeute bei Verdacht auf ein peripheres Karzinom L. Freitag1 , P. Litterst1 , B. Obertrifter1 , V. Velehorschi1 , H. P. Kemmer, A. Linder2 , I. Brightman3
  • Lungenklinik Hemer
  • 1Institut für experimentelle Pneumologie
  • 2Abteilung Thoraxchirurgie
  • 3Institut für Pathologie
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Publication History

Publication Date:
31 December 2000 (online)

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Zusammenfassung:

Die Replikationsfähigkeit normaler somatischer Zellen ist zeitlich begrenzt durch den zunehmenden Verlust ihrer chromosomalen Endstücke, der Telomere (Hayflick- Limit). Eine wesentliche Eigenschaft maligner Zellen ist die Immortalität. Der wahrscheinlich häufigste Mechanismus, durch den Tumorzellen eine scheinbar unbegrenzte Teilungsfähigkeit erlangen, ist die Aktivierung des Enzyms Telomerase, einer reversen Transkriptase, die den Verlust der Telomere rückgängig machen kann. Telomeraseaktivität konnten wir mit einem PCR-basierten TRAP-Assay in Tumorgewebsbiopsien, Ergussflüssigkeiten und Bronchiallavagen bei verschiedensten thorakalen Malignomen nachweisen.

Bei 47 Patienten mit Verdacht auf ein peripheres Bronchialkarzinom bestätigte sich durch spätere Operation oder invasive Diagnostik in 38 Fällen ein Malignom. Bei 25 von diesen 38 Patienten (66 %) war präoperativ in durchleuchtungsgestützten, bronchoskopischen Bürstenbiopsien Telomeraseaktivität nachweisbar gewesen. Es gab einen falsch positiven Fall (Tuberkulose). Mit einer Ausnahme waren die gleichzeitig entnommenen Bürstenbiopsien der Gegenseite negativ. In 23 Fällen (61 %) konnten zytologisch Tumorzellen gefunden werden. Bei 33 Patienten war mindestens ein Wert positiv. Die Kombination von Zytologie und Telomerasetest in Bürstenbiopsien erreichte damit eine diagnostische Sensitivität von 87 %.

Telomerase in Lung Cancer. Testing the Activity of the “Immortality Enzyme” in Bronchial Brush Biopsies Increases the Diagnostic Yield in Cases of Suspected Peripheral Bronchogenic Carcinomas:

The proliferative capability is time-limited in normal somatic cells by the shortening of their chromosomal ends, the telomeres (Hayflick limit). An important feature of malignant cells is their immortality. The probably most common mechanism of tumour cells to achieve unlimited replicability is the activation of the enzyme telomerase. The reverse transcriptase can compensate the loss of telomeres. Using a PCR-based TRAP assay we found telomerase activity in tumour biopsies, exsudates and bronchial washings in various thoracic malignancies.

In 38 of 47 patients with suspected peripheral lung cancer eventually surgery or invasive procedures proved a malignancy. In fluoroscopically guided bronchial brushings from 25 of these 38 patients (66 %) the TRAP assay revealed telomerase activity. There was a single false positive case (tuberculosis) and with a single exception, the simultaneously taken brushes of the contralateral lobes were all telomerase negative. In 23 patients (61 %) tumour cells were found in the cytological examination. In 33 patients at least one marker was positive. Thus the combination of cytology and telomerase test in bronchial brush biopsies attained a diagnostic yield of 87 %.

1 Herrn PD Dr. H.-N. Macha zum 60. Geburtstag gewidmet

2 Diese Studie wurde finanziert durch den Förderverein der Lungenklinik Hemer e.V.

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1 Herrn PD Dr. H.-N. Macha zum 60. Geburtstag gewidmet

2 Diese Studie wurde finanziert durch den Förderverein der Lungenklinik Hemer e.V.

PD Dr L Freitag

Lungenklinik Hemer

Theo-Funccius-Str. 1 58675 Hemer

Email: E-mail: lutzfrei@home.centernet.de