Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto, IRCCS, Via Gattamelata 64, 35128 Padova, Italy.
Br J Cancer. 2013 Feb 5;108(2):278-84. doi: 10.1038/bjc.2012.602. Epub 2013 Jan 15.
Colorectal cancer (CRC) is an important cause of cancer-related death. Prediction of recurrence is an important issue in the treatment of disease, particularly for stage II patients. The level of telomere-specific reverse transcriptase (hTERT), the catalytic component of the telomerase complex, increases along with CRC progression, but its prognostic value is still unclear.
One hundred and thirty-seven CRC patients were studied for hTERT expression in tumour cells by real-time PCR. hTERT level was evaluated as a prognostic factor of overall survival (OS) in all patients and of disease recurrence in a subgroup of 50 stage II patients.
The median hTERT level was 93.8 copies (interquartile range 48-254). Patients with high hTERT levels (above the median) showed a significantly worse survival than those with low hTERT levels (below the median; log-rank test P<0.0001; hazard ratio (HR)=3.30 (95% confidence interval (CI) 1.98-5.52); P<0.0001). The negative prognostic value of high hTERT level is independent of the pathological stage and microsatellite instability (HR=2.09 (95% CI 1.20-3.64), P=0.009). Moreover, in stage II CRC, high hTERT levels identified patients with a higher risk of disease recurrence (HR=3.06 (95% CI 1.03-9.04), P=0.043) and death (HR=3.24 (95% CI 1.37-7.71), P=0.008).
hTERT level is an independent prognostic marker of OS in CRC patients. In addition, assessment of hTERT level could improve stratification of stage II CRC patients for the risk of disease recurrence.
结直肠癌（CRC）是癌症相关死亡的重要原因。复发预测是疾病治疗中的一个重要问题，特别是对于 II 期患者。端粒特异性逆转录酶（hTERT）的水平随着 CRC 的进展而升高，hTERT 是端粒酶复合物的催化成分，但它的预后价值仍不清楚。
通过实时 PCR 研究了 137 例 CRC 患者肿瘤细胞中的 hTERT 表达。评估 hTERT 水平作为所有患者总生存（OS）的预后因素，以及 50 例 II 期患者亚组疾病复发的预后因素。
中位 hTERT 水平为 93.8 拷贝（四分位距 48-254）。hTERT 水平高（高于中位数）的患者与 hTERT 水平低（低于中位数）的患者相比，生存明显较差（对数秩检验 P<0.0001；危险比（HR）=3.30（95%置信区间（CI）1.98-5.52）；P<0.0001）。高 hTERT 水平的负预后价值独立于病理分期和微卫星不稳定性（HR=2.09（95%CI 1.20-3.64），P=0.009）。此外，在 II 期 CRC 中，高 hTERT 水平确定了疾病复发风险较高的患者（HR=3.06（95%CI 1.03-9.04），P=0.043）和死亡（HR=3.24（95%CI 1.37-7.71），P=0.008）。
hTERT 水平是 CRC 患者 OS 的独立预后标志物。此外，评估 hTERT 水平可以改善 II 期 CRC 患者疾病复发风险的分层。
