Clinical evaluation of human telomerase catalytic subunit in bladder washings from patients with bladder cancer

Purpose: We examined the expression of mRNA of human telomerase reverse tra nscriptase (hTERT), a catalytic subunit of the telomerase complex, in bladd er washings as a tumor marker for the detection of bladder cancer. Materials and Methods: Bladder washings were obtained from 63 patients. We examined the expression of hTERT mRNA by the nested reverse transcription-p olymerase chain reaction (RT-PCR) method and also measured the relative exp ressions of hTERT mRNA and beta (2)-microglobulin (beta (2)-MG) in these sa mples by RT-PCR analysis. Correlations between the relative expression of h TERT mRNA and clinical features were analyzed. We also compared the sensiti vity of this assay with that of urinary cytology, Results: By nested RT-PCR, we detected three false-positive cases (11%) in the control group. Therefore, the relative expression values of hTERT mRNA and beta (2)-MG correlated strongly with tumor size, but not with multiplic ity or histologic grade. When the cut-off value of the expression was fixed at 0.27%, the sensitivity and specificity of this assay were 74% and 93%, respectively. This assay was more sensitive than urinary cytology for the d etection of bladder cancer. Conclusion: These results suggest that the relative expression of hTERT mRN A in bladder washings is useful in screening for bladder cancer. Relative e xpression is of assistance in diagnosing bladder cancer.