Prognostic impact of telomerase activity in non-small cell lung cancers

Objective To evaluate the clinical significance of telomerase activity, particularly in terms of prognostic impact, in non-small cell lung cancer (NSCLC). Summary Background Data Telomerase activity has been found in Various tissues. The activation of te lomerase is considered necessary for the immortalization of human tumor cel ls, including NSCLC. Methods The authors studied 103 NSCLC specimens using a polymerase chain reaction b ased on a telomeric repeat amplification protocol assay. Results Telomerase activity was detected in 85 (82.5%) of 103 NSCLC specimens but i n none of the paired normal lung tissue specimens. More cases of positive t elomerase activity were observed in the group with advanced disease and in the group with poorly differentiated tumors. Such factors as the mean age a t surgery, sex, smoking, histologic type, and size of tumor extension did n ot correlate with the telomerase activity. The Kaplan-Meier survival curves in all patients with NSCLC demonstrated that patients with telomerase-posi tive tumors survived for a significantly shorter period than those with a t elomerase-negative tumor (p = 0.0058). According to a multivariate analysis , telomerase activity was identified as an independent prognostic factor (R R = 8.62, p = 0.035). Conclusions Telomerase activity was one of the most important prognostic factors in pat ients with NSCLC, and its potential prognostic implication was independent of tumor stage.