Close correlation between telomerase expression and adenomatous polyp progression in multistep colorectal carcinogenesis.

To investigate the role of telomerase in the multistep colorectal carcinogenesis, we examined telomerase activity in 31 adenomatous polyps and 22 paired cancer-normal mucosa specimens from non-hereditary nonpolyposis colorectal cancer patients. Telomerase activity was detected in 18% of normal mucosa, 16% of small (<1.0 cm) polyps, 20% of intermediate polyps, 71% of large (>2.0 cm) polyps, and 96% of adenocarcinoma samples (P for trend, <0.0001). High-level enzyme activities were seen in none of the normal mucosa, 5% of small polyps, 20% of intermediate polyps, 43% of large polyps, and 73% of adenocarcinoma samples (P for trend, <0.0001). These data indicate telomerase reactivation occurs with adenomatous polyp progression in multistep colorectal carcinogenesis.