Telomerase: Its clinical relevance in the diagnosis of bladder cancer

Abstract

More than 50 years ago, Papanicolaou recognized the importance of a non-invasive technique for the diagnosis and follow-up of patients with carcinoma of the urinary bladder. Cystoscopy, however, has remained the`gold standard' since no currently available non-invasive method can compete with cystoscopy's sensitivity and speci®city. The detection of the ribonucleoprotein telomerase or the telomerase subunits human telomerase RNA (hTR) and human telomerase reverse transcriptase (hTERT) in urine samples o er new diagnostic perspectives. The present article presents a review of publications in the literature and evaluates their clinical relevance. The experimental studies reported to date are very promising and show that telomerase exactly ful®ls the requirements for a good diagnostic marker for carcinoma of the urinary bladder. The diagnostic application remains in an experimental stage and telomerase is still several steps away for routine use as a clinical parameter. The remaining steps leading to its routine clinical application will be discussed.

Quantitative evaluation of telomerase subunits in urine as biomarkers for noninvasive detection of bladder cancer

“…34 Therefore, a higher diagnostic value of hTR seems counterintuitive at first sight. However, hTR is significantly overexpressed in malignant cells, 24 which was confirmed for bladder cancer by in situ hybridization. 35 These characteristics warrant quantification of hTR for diagnostic purposes.…”

Molecular Detection of Noninvasive and Invasive Bladder Tumor Tissues and Exfoliated Cells by Aberrant Promoter Methylation of Laminin-5 Encoding Genes

“…TCCs are subdivided into noninvasive papillary and nonpapillary invasive carcinoma types. Papillary TCCs correspond to 70% of all of the TCCs and usually are low grade, superficial, and noninvasive at the time of presentation (1)(2)(3). Papillary TCCs are characterized by high rates of recurrence, and ϳ10 -30% will progress eventually to invasive disease (3)(4)(5).…”

Human Telomerase Reverse Transcriptase (hTERT): A Target Molecule for the Treatment of Cisplatin-resistant Tumors

“…In addition, the hTR template is detected more often and at higher levels in samples obtained from bladder carcinomas than normal controls. Therefore, telomerase can identify both well-differentiated and early-stage bladder tumors [13][14][15][16]. Telomerase inhibition or inactivation increases cellular sensitivity to UV irradiation, DNA-damaging agents, the tyrosine kinase inhibitor, imatinib, and pharmacological inhibitors, such as BIBR1532 [17][18][19][20].…”