Elevated mRNA expression of human telomerase reverse transcriptase (hTERT mRNA) is common in many types of tumors, participating in tumor growth and progression. Such expression has not been sufficiently examined in renal cancer. The goal of the present study was to quantify it and analyze its possible clinical value in the management of this pathology.
The study included 111 patients who underwent surgery for renal cell carcinoma (RCC) between 2015 and 2017. Tumor samples were taken from all patients and, in 94 of them, healthy renal tissue adjacent to the tumor was also sampled. The 2 types of tissue were histologically confirmed, after which mRNA was extracted. Using real-time quantitative PCR, the expression of hTERT andglyceraldehyde-3-phosphate dehydrogenase (as endogenous control) were indirectly quantified using the crossing point (CP), which isinversely correlated with the number of sample replicates yielding positive results. These values were correlated with patient socio-demographicvariables and clinical-pathological factors of the RCC.
The majority of patients were males, with an average age of 60.5years (SD: 14.02). Most tumors (69.4%) were clear cell carcinomas. The most frequent stages were pT2 or lower (73%), while 5% were pN1 and 12% pM1. The majority of tumors (58%) were Fuhrman grades 1 or 2 (low grade). All samples of tumor and nontumor tissue expressed glyceraldehyde-3-phosphate dehydrogenase mRNA, with the CP in the tumor sample significantly lower than in the nontumor tissue (P < 0.001). The expression of hTERT mRNA was detected in 68% of tumor tissues and significantly correlated with histopathology: 100% in sarcomatoid RCC and 77.9% in clear cell carcinomas (P < 0.0001). The CP was lower in pN1 (P = 0.018), pM1 (P = 0.046), and TNM IV stages (P = 0,041). A greater number of hTERT mRNA replicas were detected in M1 patients (P = 0.0005) and TNM IV stage (P = 0.017). There was no correlation of hTERT mRNA expression with Fuhrman grade.
The quantitation of hTERT mRNA expression in RCC might be useful as a complementary diagnostic tool as well as for assessing aggressiveness of the tumor.
Urologic oncology. 2019 Apr 08 [Epub ahead of print]
Carlos Martínez-Sanchíz, Dolores C García-Olmo, María G Picazo-Martínez, Syongh Y Nam-Cha, José M Giménez-Bachs, Ana B Flores-Bautista, Ángela Díaz-Piqueras, Antonio S Salinas-Sánchez
Urology Departament, Complejo Hospitalario y Universitario, Faculty of Medicine, Castilla La Mancha University, Albacete, Spain., Centre de Recerca Experimental Biomèdica Aplicada (CREBA), Institut de Recerca Biomèdica, Torrelameu, Lleida, Spain., Research Unit, Complejo Hospitalario y Universitario, Faculty of Medicine, Castilla La Mancha University, Albacete, Spain., Patology Department, Complejo Hospitalario y Universitario, Faculty of Medicine, Castilla La Mancha University, Albacete, Spain., Urology Departament, Complejo Hospitalario y Universitario, Faculty of Medicine, Castilla La Mancha University, Albacete, Spain. Electronic address: assalinas@sescam.jccm.es.