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Updated: May 31, 2025
Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Analysis of TERT mRNA Levels and Clinicopathological Features in Patients with Peritoneal Mesothelioma
Antonio d'Amati1,2,3, Gabriella Serio3, Andrea Quaranta3
1Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy.
Background/Objectives:
Telomerase reverse transcriptase (TERT) is the catalytic subunit of the telomerase enzyme responsible for telomere length maintenance and is an important cancer hallmark. Our study aimed to clarify the mRNA expression of TERT in peritoneal mesothelioma (PeM), and to explore the relationship between its expression and the clinicopathological parameters and prognosis of patients with PeM.
Methods:
In a cohort of 13 MpeM patients, we evaluated histotype, nuclear grade, mitotic count, necrosis, inflammation, Ki67, BAP1, MTAP and p16 expression by immunohistochemistry, p16/CDKN2A status by FISH and TERT mRNA expression by RNAscope.
Results:
Our results showed several statistical correlations between TERT mRNA-score and other investigated features: (i) a poor positive correlation with BAP1 score (r = 0.06340; p ≤ 0.0001); (ii) a moderate positive correlation with p16 FISH del homo (r = 0.6340; p ≤ 0.0001); (iii) a fair negative correlation with p16 FISH del hetero (r = -0.3965; p ≤ 0.0001); a negative poor correlation with MTAP (r = -0.2443; p ≤ 0.0001); and (iv) a negative fair correlation with inflammatory infiltrate (r = -0.5407; p = 0.0233). Moreover, patients survive for a significantly longer time if they have a low mitotic index adjusted (2-4 mitotic figures per 2 mm2) (p ≤ 0.0001), are male (p = 0.0152), lose BAP1 (p = 0.0152), are p16 positive and present no deletion or heterozygous for p16 (p ≤ 0.01).
Conclusions:
TERT is highly expressed in PeM, but it is not one of the crucial factors in evaluating the prognosis of patients. Nevertheless, the results validate the prognostic significance of the mitotic index, BAP1 loss and p16/CDKN2A status.
Insights
Telomerase reverse transcriptase (TERT) mRNA is highly expressed in peritoneal mesothelioma (PeM). However, TERT expression does not significantly impact patient prognosis, unlike mitotic index, BAP1 loss, and p16/CDKN2A status.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Telomerase reverse transcriptase (TERT) is crucial for telomere maintenance and a hallmark of cancer.
- Peritoneal mesothelioma (PeM) is a rare and aggressive malignancy.
- Understanding TERT expression in PeM is vital for prognostic evaluation.
Purpose of the Study:
- To investigate TERT mRNA expression in peritoneal mesothelioma (PeM).
- To correlate TERT expression with clinicopathological parameters and patient prognosis in PeM.
Main Methods:
- Analysis of TERT mRNA expression using RNAscope in 13 PeM patient samples.
- Evaluation of histotype, nuclear grade, mitotic count, necrosis, inflammation, Ki67, BAP1, MTAP, and p16 by immunohistochemistry.
- Assessment of p16/CDKN2A status using FISH.
Main Results:
- TERT mRNA expression showed correlations with BAP1, p16 FISH (homo/hetero), MTAP, and inflammatory infiltrate.
- Patients with low mitotic index, male gender, BAP1 loss, or p16 positivity (no/heterozygous deletion) had significantly longer survival.
- TERT mRNA expression was not a primary prognostic factor.
Conclusions:
- TERT is highly expressed in PeM but not a key prognostic indicator.
- Mitotic index, BAP1 loss, and p16/CDKN2A status are validated as significant prognostic factors in PeM.
- Further research may explore the role of TERT in PeM pathogenesis.
