RESUMO
Objective To study the clinical significance of urinary hTERT in diagnosis and follow up of transitional cell carcinoma of urinary bladder.Methods Semi-quantitative RT-PCR was used to detected the expression of hTERT mRNA expression in 42 cases with bladder transitional carcinoma and 40 patients without carcinoma of bladder.Regular urine cytology results were compared with the expression of hTERT.Following-up observision of the changes of hTERT mRNA expression and its relation with recurrency in 36 cases of transitional cell carcinoma of urinary bladder was conducted.Results 30 0f 42 cases with bladder transcriptional carcinoma were found positive expression of hTERT.but only 3 in the control group of 40 cases presented the positive expression of hTERT.The overall sensitivity and specificity for hTERT were 71.43%and 92.50%.The sensitivities for hTERT were 50.00%,73.68%and 90.91%respectively in G1-G3 tumor.The urine hTERT expression level significantly increased with the tumor grade and clinical staging.The sensitivity and the specificity of urinary cytology were 19.05%and 100%.Compared with hTERT.the cytology had lower sensitivity and no difference in specificity.The recurrence of the tumor was found in 6 patients.8-16 weeks after positive expression of hTERT,cystoscope confirmed recurrence of bladder carcinoma.Conclusions hTERT is a tumor marker of transcriptional carcinoma of bladder.because of its relatively high sensitivity and specificity.Detection of hTERT in urine sediment is superior to traditional cytology.The urine hTERT rate significantly increases with the tumor grade and the clinical stage.hTERT can indicate recurrence of bladder carcinoma.so it is valuable to the monitoring of recurrence of transcriptional cell carcinoma of bladder.