Telomerase activity in sex cord-stromal tumors of the ovary

Objective. Telomerase is a ribonucleoprotein that protects chromosomes from degradation and end-to-end fusions by maintaining telomere length. Studies have shown that telomerase is present in 95% of gynecologic malignancies a nd in 88% of epithelial ovarian carcinomas but undetectable in benign tissu e. The aim of this investigation was to determine whether telomerase is pre sent in sex cord-stromal tumors and whether telomerase activity is indicati ve of patient outcomes. Methods. Forty-five consecutive sex cord-stromal ovarian tumors were analyz ed by using reverse transcription-polymerase chain reaction for expression of human telomerase, human telomerase reverse transcriptase, and telomerase activity. Results. Of the 29 patients with malignant cell types (granulosa cell, Sert oli-Leydig cell, and steroid cell tumors), 21 of the 28 patients (75%) avai lable for follow-up had recurrence, with a mean follow-up of 86 months (95% CI, 36-157 months). The telomerase repeat amplification protocol assay had a sensitivity of 74% and specificity of 94% for malignancy. Patients with telomerase-positive tumors had a mean disease-free interval of 66.5 months; for those with telomerase-negative tumors the interval was 90 months. In a ddition, patients with telomerase-positive tumors were more likely to be de ad from disease or alive with disease than those without telomerase activit y, and they showed trends toward requiring a larger number of surgical proc edures for the treatment of their disease. However, these trends were not s tatistically significant. Conclusion. Although activation of telomerase is clearly an important step in carcinogenesis, it is unlikely to be helpful in the clinical management of sex cord-stromal tumors of the ovary. (C) 2001 Academic Press.