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Eur J Cardiothorac Surg 2009;36:460-464. doi:10.1016/j.ejcts.2009.03.057
Copyright © 2009, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Study of telomerase activity in pleural lavage fluid specimens in patients with non-small-cell lung cancer and its clinical significance

Weidong Lia, Yiming Nia, Zhengliang Tua, Shengjun Wua, Zhiyong Wua,*, Shusen Zhengb,**

a Department of Cardiothoracic Surgery, 1st Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, PR China
b Key Lab of combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou 310003, PR China

Received 1 March 2008; received in revised form 19 March 2009; accepted 23 March 2009.

* Corresponding author. Tel.: +86 571 87236841; fax: +86 571 28918695. (Email: zyxxlwd{at}hotmail.com; zyzss{at}hotmail.com).
** Corresponding author. Tel.: +86 571 87236577; fax: +86 571 87236577. (Email: zyxxlwd{at}hotmail.com; zyzss{at}hotmail.com).

Objective: To detect telomerase activity in pleural lavage fluid specimens in patients with non-small-cell lung cancer (NSCLC) and to evaluate its clinical value. Methods: From July 2005 to May 2007, 167 pleural lavage fluid specimens were obtained from 135 patients with NSCLC and 32 patients with benign lung tumour during operation. Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity in these specimens. Pleural lavage cytology (PLC) analysis of the pleural lavage fluid specimens was used for comparison. All the above specimens were examined within 3 h. Results: The positive rate of telomerase activity and PLC in pleural lavage fluid from patients with NSCLC was 25.2% (34/135) and 8.1% (11/135), respectively, with a significant difference (P < 0.05). Telomerase activity was detected in all 11 specimens with positive cytological examination. Telomerase activity was negative in all 32 patients with benign lung tumour. There was a significant relationship between telomerase activity and pleural extension, T level, N level as well as the clinical TNM (tumour, node, metastasis) stage of lung cancer. A significant association was found between positive telomerase activity and overall survival rate, even stage I survival rate. Multivariate Cox regression analysis demonstrated that telomerase activity, as well as PLC and the TNM stage were independent predictors of prognosis. Conclusion: Telomerase activity is a useful adjunct for cytological method in the diagnosis of pleural micro-metastasis and was related to prognosis in a patient with NSCLC.

Key Words: Telomerase activity • Pleural lavage fluid • Lung cancer • Surgical resection






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Copyright © 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.