Telomerase: a potential marker of bladder transitional cell carcinoma in bladder washes

Telomerase is an enzyme that immortalizes cells by maintaining a constant telomere length. Here, telomerase activity in bladder washes was analyzed and compared with the final pathological diagnosis in 23 patients with bladder transitional cell carcinoma (TCC). Bladder washes and normal tissues were obtained from each patient prior to transurethral resection of bladder tumor. Telomerase activity was detected using telomeric repeat amplification protocol assay based on PCR. Cytological diagnosis of centrifuged cells from bladder washes was made using Papanicolau's stain. Results demonstrated that telomerase activity was detected in 95.7% of both cancer tissues and bladder washes. In normal tissues, telomerase activity was not detected in 22 of 23 samples. Regarding cytological diagnosis, only 69.6% of bladder wash samples had positive cytology. Moreover, in five cases of grade 1 TCC, only 20% of the cytological specimens were positive for malignancy, whereas 80% showed positive telomerase activity. These results demonstrate that telomerase activity is detectable in a majority of human bladder cancer tissues and bladder washes obtained from patients with TCC. In addition, results of this study suggest that the presence of telomerase in bladder washes may be a specific marker of bladder cancer, especially in low-grade tumors.