Detection of Telomerase Activity of Exfoliated Cells in Bile and Its Clinical Impact

Background Objective:Some studies revealed that telomera se activity could be detected in exfo liated cancer cells in body fluid such as urine,pancreatic juice,pleural effusion that is a good diagnostic marker f or malignancies.However,few reports about telomera se in exfoliated cancer cells in bile are available.The current study was designed to determine the telomerase activity o f exfoliated cells in bile and its clinical impact in the patients with malignant obstructive jaundice.Methods:Telomerase activity was determined by using a modified PCR-based telome ric repeat amplification protocol(TRAP)-sliver stain assay.Result:Telomerase activity was detected in33of 44(75%)bile specimens from patients with malignant tumor.In contrast,only 1of 19(5.3%)bile samples from cholelithiasis wa s telomerase positive.There was no relation ship between the positiv e rate of telomerase activity and the clinicopathological finds includi ng metastatic status and differentiation,but telomerase positive rate was higher in bile fro m patients with pancreatic carcionm a and cholangiocarcinoma.Comparison of telomerase assay with cytologic examination showed that,among the 44patients with malignant obstructive jaundice,31cases underwent cytological examin ation,cancer cells were found only i n 3(9.7%)bile specimens,and all cytological exam ination positive specimens were telomerase positive.Conclusion:The TRAP assay can effectively detect telomerase activity of the exfoliated cancer cells in bile.Telomerase could be a molecu lar marker for diagnosis of malignan t bile duct disease.The detection of telomerase activity in bile could become a usefu l adjunct in the cytologic examinati on.