Diagnostic and prognostic relevance of expression of human telomerase subunits in oral cancer.

Telomerase activity (TA) is associated with most malignant human tumors but is not detected in normal somatic cells with a few exceptions. Three major subunits (hTR, hTP1 and hTERT) of telomerase have been identified. To investigate the clinical implications of the mRNA detection of these components as useful diagnostic and prognostic markers in oral cancer, we examined TA, hTR, hTP1 and hTERT mRNA expressions in 46 oral squamous cell carcinomas (OSCC) and 15 normal oral mucosal tissues from healthy volunteers using a highly sensitive TRAP assay and RT PCR. In all specimens hTR and hTP1 mRNA were detected regardless whether TA was expressed or not. On the contrary, a significant correlation between hTERT expression and TA was shown indicating that the activity of telomerase could be regulated by the extent of hTERT transcription. In addition, hTERT expression showed close association to malignancies. None of the normal mucosal specimens expressed the hTERT subunit, but 76% (35/46) of the tumor specimens did. None of other clinico-pathological and prognostic parameters showed significant relationship with TA or hTERT expression. These results suggest that the detection of hTERT expression may be another useful diagnostic marker, especially for early detection of OSCC, and for distinguishing healthy tissues from neoplastically transformed ones.