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Eur J Cardiothorac Surg 2004;26:425-431
© 2004 Elsevier Science NL

Correlation between telomerase expression and terminal restriction fragment length ratio in non-small cell lung cancer—an adjusted measurement and its clinical significance

^a Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 407, Taiwan, ROC
^b School of Medicine, National Yang Ming University, Taipei, Taiwan, ROC
^c School of Medicine, Chung Shang Medical University, Taichung, Taiwan, ROC

Received 29 January 2004; received in revised form 25 March 2004; accepted 5 April 2004.

^* Corresponding author. Address: Division of Thoracic Surgery, Department of Surgery, Taichung Veterans General Hospital, 160, Sec. 3, Taichung-Kang Rd, Taichung 407, Taiwan, ROC. Tel.: +886-4-23592525x5050; fax: +886-4-23599715
e-mail: cliff{at}vghtc.gov.tw

Objective: To establish a new model for analyzing the correlation between the terminal restriction fragment (TRF) length and telomerase activity in non-small cell lung cancer (NSCLC) patients due to inconsistent results in previous reports. Methods: Between January 1999 and December 1999, 79 NSCLC patients were studied. The activity of telomerase was measured by telomeric repeat amplification protocol, and the telomere restriction fragment (TRF) length was measured by Telomere Length Assay Kit and Southern blotting. The correlation between expression of telomerase activity and the TRF length ratio (TRFLR) using the tumor-to-normal TRFLR (t/n TRFLR) was examined. Results: Positive telomerase activity was observed in 48 (60.8%) of the tumor tissue samples and in 5 (6.3%) of the normal tissue samples (P<0.0001). The mean TRF lengths were 5.32±1.53 kb in normal tissue samples and 3.95±1.92 kb in tumor tissue samples, respectively (P=0.0001). The 4-year cumulative survival rates of lower t/n TRFLR (75%) and higher t/n TRFLR (>75%) patients were 69.2 and 41.2%, respectively (P=0.0227). Independent prognostic factors include t/n TRFLR (P=0.014), T-status (P=0.027), and N-status (P=0.020) of the tumor. Conclusions: Our data suggest that there is a good correlation between the t/n TRFLR and expression of telomerase activity. A higher t/n TRFLR may indicate that the tumor regains its ability to repair the telomere lost and escapes the apoptosis scenario, which is subsequently reflected in poorer patient outcomes.

Key Words: Telomere • Telomerase • Terminal restriction fragment length • Lung cancer

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