Telomerase activity in the differentiation of benign and malignant adrenaltumors

Background, Telomerase is an RNA-dependent DNA polymerase that extends the ends of chromosomes by synthesizing the 6 oligonucleotide repeat TTAGGG and thus serves as a marker for cellular immortality. Although absent in most adult somatic tissues, telomerase activity is present in stem cells and is reactivated in nearly all primary human malignancies. In this study we soug ht to determine whether tumors of the adrenal glands contain telomerase act ivity and whether. telomerase activity can be used to differentiate benign and malignant tumors of the adrenal glands. Methods. Tissue was obtained from 23 specimens at adrenalectomy. Adjacent n ormal adrenal tissue was obtained for control. All specimens were rapidly f rozen and stored at -80 degrees C until assay. Telomerase activity was dete rmined by the telomeric repeat amplification protocol (TRAP). Results, Telomerase activity was present in 5 of 23 (22 %) of the adrenal t umors. All 3 malignant tumors were strongly TRAP positive. There was a sing le cortical adenoma that had very weak telomerase activity. The single TRAP -positive tumor of the adrenal medulla was a ganglioneuroma. Conclusions. Benign adrenal tumors infrequently contain telomerase activity , whereas telomerase reactivation appears to be common in malignant tumors of the adrenal glands. These data suggest that determination of telomerase activity may offer a novel way to facilitate the differentiation of benign and malignant adrenal tumors.