Telomerase activity detected by quantitative assay in bladder carcinoma and exfoliated cells in urine

Early diagnosis is one of the most determining factors for patient survival . The detection of telomerase activity is a potentially promising tool in t he diagnosis of bladder and other types of cancer due to the high expressio n of this enzyme in tumor cells. We carried out a quantitative evaluation o f telomerase activity in urine samples in an attempt to determine a cut-off capable of identifying cancer patients. Telomerase activity was quantified by fluorescence TRAP assay in urine from 50 healthy volunteers and in urin e and bioptic tumor samples from 56 previously untreated bladder cancer pat ients and expressed in arbitrary enzymatic units (AEU). Telomerase activity in urine ranged from 0 to 106 AEU (median 0) in healthy donors and from 0 to 282 AEU (median 87) in patients with cancer. A telomerase expression hig her than the cut off value determined by receiver operating characteristic (ROC) analysis was observed in 78% of cases, regardless of tumor grade and in 71% (15/21) of cases of nonassessable or negative cytology. The quantita tive analysis of telomerase activity in urine enabled us to define cut-off values characterized by different sensitivity and specificity. Cytologic an d telomerase determination, used sequentially, enabled us to detect about 9 0% of tumors.