Clinical Significance of Telomerase Activity and Human Telomerase Reverse Transcriptase mRNA Expression for Differential Diagnosis of Malignant and Benign Liver Lesions

OBJECTIVE To study the clinical significance of telomerase activity and human telomerase reverse transcriptase (hTERT) mRNA expression for differential diagnosis of malignant and benign liver lesions.

METHODS Telomerase activity was determined by an ELISA-based telomeric repeat amplification protocol (ELISA-TRAP) assay on 130 surgical resected liver samples and 58 percutaneous biopsied liver samples. In addition, the samples were assayed for expression of hTERT mRNA measured by a reverse transcriptase-polymerase chain reaction (RT-PCR). Postoperative pathological examinations were also performed on these samples.

RESULTS Among the 130 surgical liver samples, the positive rates of telomerase activity in hepatocellular carcinoma (HCC), liver cirrhosis and chronic hepatitis tissues were 85.9% (55/64), 25.0% (8/32) and 8.3% (2/24) respectively, and the positive rates of hTERT mRNA expression were 89.1% (57/64), 25.0% (8/32) and 8.3% (2/24) respectively. Neither telomerase activity nor hTERT mRNA expression was detected in 10 normal liver tissues. Among the 58 biopsied liver specimens, the positive rates of telomerase activity in HCC, cholangiocellular carcinoma, focal nodular hyperplasia, inflammatory pseudotumor and adenomatous hyperplasia tissues were 85.7% (30/35), 100% (4/4), 33.3% (4/12), 25.0% (1/4) and 33.3% (1/3) respectively, and the positive rates of hTERT mRNA expression were 88.6% (31/35), 100%(4/4), 33.3%(4/12), 25.0%(1/4) and 33.3%(1/3) respectively. The positive level of telomerase activity and hTERT mRNA expression in malignant liver tumors was significantly higher than that found in benign liver lesions (P<0.01).

CONCLUSION Determination of telomerase activity or hTERT mRNA expression in percutaneous biopsied liver tissues may be useful for differential diagnosis in malignant and benign liver lesions.