The aim of this study was to define the clinical implications of semi-quantitative
telomerase activity in gynecological
tumors by comparing the
telomerase activity of cancerous lesion and the adjacent non-cancerous lesion. In 118 cases of gynecologic
tumors, including 41 uterine cervical
tumors, 43 uterine body
tumors and 34 ovarian
tumors,
telomerase activities were determined using TRAPeze
telomerase detection kit for the extension reaction of the telomere sequence and the PCR reaction for amplification of the sequence, and using fluorecence-based telomere repeat amplification protocol (F-TRAP) method for the detection. In all gynecologic
cancers examined,
telomerase activity of the cancerous lesion was significantly higher than that of the non-cancerous lesion.
Telomerase activity in the uterine cervix increased in the following order of the normal uterine cervix,
cervical dysplasia and
cervical cancer. Regarding the
endometrial cancer,
telomerase activity at the primary lesion in patients with
lymph node metastases was significantly higher than that in patients without
lymph node metastases. When
telomerase activity was compared by histologic subtypes of the
ovarian cancer,
clear cell adenocarcinoma showed significantly lower
telomerase activity than the other subtypes, especially
endometrioid adenocarcinoma. In all gynecologic
cancers examined, there was no clear correlation between the
telomerase activity and age at diagnosis or age of menopause. Although all
tumors with 100 units or more
telomerase activity were cancerous, the sensitivity was 39% in
cervical cancer, 41% in
endometrial cancer and 21% in
ovarian cancer, respectively.
Cervical intraepithelial neoplasia (CIN) had already increased
telomerase activity and
endometrial cancer with
lymph node metastases had also greater activity than that without
lymph node metastases. Although
telomerase activity in
ovarian cancer tended to increase as stage advances, it is noteworthy that
clear cell adenocarcinoma showed significantly lower
telomerase activity than
endometrioid adenocarcinoma.