[Quantitative analysis of telomerase activity in exfoliated urothelial cells for the diagnosis of bladder carcinoma].

Voided urine cytology is the most common non-invasive examination for the detection and monitoring of bladder cancer. However, the result is not satisfactory, especially for low grade tumors. Activity of telomerase can be detected in most tissues of bladder carcinoma using the telomeric repeat amplification protocol (TRAP) assay. We analyzed the quantitative telomerase activity in exfoliated urothelial cells, and evaluated the values for early diagnosis of bladder carcinoma. We performed a quantitative analysis using a hybridization protection assay (HPA) based on TRAP assay. Telomerase activity was significantly higher level in exfoliated urothelial cells from patients with bladder cancer than all of healthy cases and patients with benign disease (p < 0.0001). The cut off value was calculated as mean + 2SD of the telomerase activity level of the exfoliated urothelial cells from healthy cases. Using this cut off value, telomerase activity was positive in 26 of 41 in exfoliated urothelial cells from bladder cancer patients(63.4% sensitivity), and negative in 63 of 69 in exfoliated urothelial cells from healthy cases and patients with benign disease (91.3% specificity). The sensitivity of telomerase activity in exfoliated cells was higher than urinary cytology, especially in low grade tumors. Our results indicate that quantitative analysis of telomerase activity in exfoliated urothelial cells could become minimum invasive and useful method for detection of bladder carcinoma.