[Clinical implications of telomerase activity in breast cancer fine-needle aspirates]

To study the telomerase activity in samples of breast fine-needle aspirates, its clinical implications, and possible association with expression of PR, ER, PCNA, c-erbB2 and p53.

Ninetynine fine needle aspirates from breast cancers in 83 patients, 12 from benign lesions and 4 from inflammation of the breast, were examined for telomerase activity by a PCR-based telomere repeat amplification protocol (PCR-TRAP). In 35 breast cancer tissue specimens, expression of PR, ER, PCNA, c-erbB2 and p53 were examined by immunohistochemical staining.

Among 83 fine-needle aspirates from breast cancer, telomerase activity was detected in 61 of 69 cytology-possitive specimens and in 5 of 7 cytology-suspicious specimens and in 4 of 7 cytology-negative specimens, with an overall positive rate of 84.3% (70/83). The concordance rate of telomerase detection and cytologic examination was 77.1% (64/83). Of 12 fine-needle aspirates from patients with benign breast lesions, 4 were telomerase positive, but 4 aspirates from inflammed breast were all negative. Telomerase activity of breast cancer aspirates did not correlate with histologic type, lymph node status, tumor size and clinical stage, nor did it correlate with PR, ER status and PCNA and c-erbB2 expression. However, negative correlation was found between telomerase activity and accumulation of p53 proteins.

Detection of telomerase in breast fine-needle aspirates complementary to cytological examination is useful in the diagnosis of breast cancer. Its possible association with p53 accummulation needs further study.