Background: Telomerase activity is detectable in more than 85% of primary c
ancers. We determined telomerase activity in biopsy specimens obtained from
biliary tract cancers to evaluate the clinical application of telomerase a
ctivity detection in combination with p53 immunostaining and routine histol
ogic examination.
Methods: Biospy specimens obtained during percutaneous transhepatic cholang
ioscopy from 13 patients with cholangiocarcinoma, 3 patients with gallbladd
er carcinoma, and 4 patients with intrahepatic bile duct stones were evalua
ted by routine histologic examination, p53 Immunostaining, and telomerase a
ctivity. Semiquantitative determination of telomerase activity was performe
d using a fluorescence-based telomeric repeat amplification protocol.
Results: Thirteen of 16 specimens of malignant tissue had detectable telome
rase activity, whereas no specimen of nonmalignant tissue had detectable te
lomerase activity. A p53 overexpression was recognized by immunostaining in
9 of 16 samples with cancers. Combining both telomerase activity and p53 o
verexpression resulted in the detection of all cancer with a sensitivity of
100%. There were no false-positive results by either modality (specificity
100%).
Conclusions: The detection of telomerase activity in biopsy specimens and p
53 overexpression in combination with routine histologic examination may im
prove the diagnosis of biliary tract cancers.