Prognostic relevance of hTERT mRNA expression in ductal adenocarcinoma of the pancreas

Abstract

Telomerase is thought to play an essential role in tumourigenesis and progression. Its activity is directly correlated with the expression of its catalytic subunit, hTERT. A correlation of transcript expression with a poor prognosis has been detected in different human malignancies. However, data on hTERT in pancreatic ductal adenocarcinoma (PDAC) are purely descriptive so far. Therefore, we evaluated the impact of hTERT expression on patients' prognosis. hTERT mRNA isolates from fifty-six human microdissected PDAC tissues were analyzed by quantitative RT-PCR and multivariate Cox's regression hazard test. Elevated hTERT transcript levels were measured in 23 out of 56 PDAC tissues, 33 patients showed no detectable transcripts. Unexpectedly, low expression of hTERT mRNA levels was associated with a worse prognosis for overall survival (relative risk (RR)=5.33; P=0.013) when compared to high levels, whereas undetectable expression showed an intermediate risk of tumour-related death. These data challenge previous findings outlining hTERT's negative impact on overall survival. The risk-pattern obtained in PDAC suggests a more complex regulation of hTERT.