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Semi-quantitative Detection of RNA-dependent RNA Polymerase Activity of Human Telomerase Reverse Transcriptase Protein
Published on: June 12, 2018
Emerging targets in upper tract urothelial carcinomas: the TERT gene
Andrés Ortíz Restrepo1, Jeffrey S Ross2, Philippe E Spiess3,4,5
1UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia.
Introduction:
Urothelial carcinoma (UC) is the fourth most prevalent malignancy in adults, accounting for 2.1% of cancer-related deaths. We aimed to describe the most frequent telomerase reverse transcriptase (TERT) gene mutations in this type of cancer and their relationship with the prognosis and treatment of this disease.
Materials And Methods:
We performed a search strategy in Medline and Embase with the following keywords: telomerase reverse transcriptase (TERT) gene and upper tract UC. We included reviews and observational studies to support the statements throughout the manuscript.
Results:
The transcriptional activation of the TERT gene and subsequent telomerase activity is a prerequisite step in malignant transformation and progression. In advanced upper tract UC, TERT mutations are the most common genomic alterations in the Foundation Medicine database. C228T mutations predict distant metastasis in 60% of patients with renal pelvis cancer and 11% with ureteral cancer. Also, C228T and C250T mutations in urine DNA had a sensitivity of 87% and specificity of 94.7%. All TERT genomic alterations are inactivating short variant sequence mutations. There are no copy number gains or losses in TERT and no TERT gene rearrangements or fusions.
Conclusions:
Multiple markers, and mutations regarding the TERT gene and its promoter have been found in upper tract UC. The C250T and C228T mutations have shown promising results as diagnostic markers detected with urine tests.
Insights
Telomerase reverse transcriptase (TERT) gene mutations are common in upper tract urothelial carcinoma (UTUC). Specific TERT mutations, C228T and C250T, show potential as non-invasive diagnostic markers in urine for UTUC.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Urothelial carcinoma (UC) is a significant cause of cancer-related mortality.
- Telomerase reverse transcriptase (TERT) gene activation is crucial for cancer development and progression.
Purpose of the Study:
- To identify frequent telomerase reverse transcriptase (TERT) gene mutations in upper tract urothelial carcinoma (UTUC).
- To investigate the association between TERT mutations and UTUC prognosis and treatment.
Main Methods:
- Literature search in Medline and Embase databases.
- Inclusion of reviews and observational studies on TERT gene and upper tract UC.
Main Results:
- TERT mutations are the most frequent genomic alterations in advanced upper tract UC.
- C228T mutations correlate with distant metastasis in renal pelvis and ureteral cancers.
- TERT mutations (C228T, C250T) in urine DNA demonstrate high sensitivity and specificity for UTUC detection.
Conclusions:
- TERT gene promoter mutations are prevalent in upper tract UC.
- C250T and C228T mutations are promising diagnostic biomarkers for UTUC, detectable via urine tests.
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