Telomerase in relation to clinicopathologic prognostic factors and survival in cervical cancer

We investigated, in cervical cancer, the relation between telomerase activi ty, telomerase RNA (hTR) and mRNA of the catalytic subunit of telomerase, h TERT, with "classic" clinicopathological factors as well as survival. Froze n specimens were obtained from 107 consecutive patients with cervical cance r, treated with surgery or radiotherapy with or without chemotherapy. Telom erase activity was determined with fluorescence-based TRAP and hTR and hTER T with semi-quantitative RT-PCR, Eight normal cervical specimens served as controls, Analysis of prognostic factors and survival was limited to early- stage patients, treated primarily with radical hysterectomy. Telomerase act ivity was not detected in normal cervices and was present in 85 of 107(79%) cervical cancers (p < 0.001), hTR was detected in all normal cervices and cervical cancers, while hTERT mRNA was detected in I of 8 (13%) normal cerv ices and in 83 of 104 (80%) cervical cancers (p < 0.001), In contrast to se mi-quantitative hTR expression levels, semi-quantitative hTERT mRNA levels were related to telomerase activity levels (P < 0.01), In all patients, tel omerase activity levels were related to differentiation grade (p < 0.05) bu t not to stage and histotype, In early-stage patients, telomerase activity, hTR and hTERT were not related to tumor volume, vascular invasion or prese nce of metastatic lymph nodes. Tumor volume, vascular invasion and presence of metastatic lymph nodes were related to (progression-free) survival, whi le telomerase activity and its subunits were not. Frequent up-regulation of telomerase activity and hTERT mRNA is especially observed in cervical canc ers, while hTR is also detected in normal cervices. Telomerase is not appli cable as a prognostic factor in early-stage cervical cancer patients. (C) 2 001 Wiley-Liss, Inc.