RESUMO
BACKGROUND & OBJECTIVE: Some studies revealed that telomerase activity could be detected in exfoliated cancer cells in body fluid such as urine, pancreatic juice, pleural effusion that is a good diagnostic marker for malignancies. However, few reports about telomerase in exfoliated cancer cells in bile are available. The current study was designed to determine the telomerase activity of 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 telomeric repeat amplification protocol(TRAP)-sliver stain assay. RESULT: Telomerase activity was detected in 33 of 44(75%) bile specimens from patients with malignant tumor. In contrast, only 1 of 19(5.3%) bile samples from cholelithiasis was telomerase positive. There was no relation ship between the positive rate of telomerase activity and the clinicopathological finds including metastatic status and differentiation, but telomerase positive rate was higher in bile from patients with pancreatic carcinoma and cholangiocarcinoma. Comparison of telomerase assay with cytologic examination showed that, among the 44 patients with malignant obstructive jaundice, 31 cases underwent cytological examination, cancer cells were found only in 3(9.7%) bile specimens, and all cytological examination 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 molecular marker for diagnosis of malignant bile duct disease. The detection of telomerase activity in bile could become a useful adjunct in the cytologic examination.
