Detection of Telomerase Activity Using a Quantitative Assay and Immunohistochemistry Techniques In Urinary Bladder Lesions

Telomerase activity is found in 85%-90% of all human cancers and absent in most of the normal cells and thus represents a potential cancer biomarker. Our aim was assessment of telomerase activity by TRAP method and to detect, localize cellular telomerase expression (hTERT) by immunohistochemistry technique in tissue samples of bladder lesions and to correlate the results with clinicopathological parameters( histopathological grade and stages). Bladder specimens were obtained from 85 patients and 10 cases served as control. Telomerase activity by PCR-ELISA technique was measured using TRAP (telomeric repeat amplification protocol) technique and immunohistochemistry (IHC) method was performed on paraffin sections to detect the protein human telomerase reverse transcriptase (hTERT). The patient group included 75 males and 10 females, fifty nine of our patients (59/85) have proven to be associated with schistosomiasis. TRAP activity was detected in 48/60 bladder cancer cases (80%), non schistosomal urothelial carcinoma (non Sch. urothelial carcinoma) (71.4%), Sch. urothelial carcinoma (75%) while were (100%) in squamous cell carcinoma (SQCC). TRAP activity was positive in 100 % of high grade urothelial carcinoma compared to low grade urothelial carcinoma 50% and 92% positive in invasive tumors compared to superficial tumors 50%. hTERT protein expression was detected in (86.6 %) of bladder cancer cases; non Sch. urothelial carcinoma (80.9 %), Sch. urothelial carcinoma (87.5%) while in SQCC it was (93.3). In addition; hTERT was positive in 100% of high grade and invasive urothelial carcinoma compared to low grade 70.8% and superficial 65% urothelial carcinoma. We conclude that both TRAP and hTERT protein increased in SQCC and urothelial carcinoma than in non cancerous cases and also was higher in SQCC than urothelial carcinoma. Both methods may be used for the detection of telomerase activity bladder cancer. TRAP activity could be a promising diagnostic marker in addition to other hestological parameters.The significant value of TRAP in cancer bladder is not only based on its diagnostic validity but also on its poor prognostic impact in those patients thus widening the range of application of this technique in future.

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