Telomerase activity in gestational trophoblastic disease

Aims-To investigate the pattern of telomerase activity in hydatidiform mole as compared with normal placenta and choriocarcinoma, and to determine the prognostic significance of telomerase activity in hydatidiform mole. Methods-Telomerase activity in 35 cases of hydatidiform mole, 35 normal pla centas, one choriocarcinoma sample, and two choriocarcinoma cell lines (JAR , JEG3) was determined using the sensitive polymerase chain reaction based telomeric repeat amplification protocol (TRAP) assay. Two cases of breast c arcinoma and two cases of ovarian carcinoma were also included as positive controls in the telomerase assay. Results-Telomerase activity was detected in 11 of 30 early placentas (36.7% ), one of five term placentas (20%), five of 27 hydatidiform moles which re gressed spontaneously (18.5%), and six of eight hydatidiform moles which de veloped persistent trophoblastic disease (75%) (including three which devel oped metastases). Hydatidiform moles which subsequently developed persisten t disease, especially those which metastasised, were more likely to express telomerase activity (p<0.01). However, there was no Significant difference in the frequency of telomerase activity between early placentas and hydati diform mole. Strong telomerase activity was observed in choriocarcinoma tis sue, choriocarcinoma cell lines, and ovarian and breast carcinomas. Conclusions Telomerase activation occurs in hydatidiform mole with a simila r incidence to early normal placentas. This supports the concept that hydat idiform mole is essentially an abnormal conceptus. There is an association between telomerase activation and the development of persistent trophoblast ic disease. Further study is warrant to confirm the prognostic significance of telomerase activity in hydatidiform mole.