Full-length telomerase reverse transcriptase messenger RNA is an independent prognostic factor in XXXX .

@entity5 @entity4180 @entity2215 @entity521
Telomerase activity (TA) is the most recently recognized prognostic factor in @entity521 , and its outstanding predictive power was documented by several studies. However, TA measurements require fresh @entity5 tissue that is not always available in daily clinical practice. We previously described a reverse transcriptase-polymerase chain reaction assay that we used to investigate the possible prognostic relevance of the telomerase catalytic subunit, @entity2215 , at the mRNA level. Because @entity2215 mRNA undergoes alternative splicing as a regulatory mechanism of TA, we discriminated between truncated and full-length @entity2215 transcripts. In a retrospective study on 124 @entity521 , 56 (45.2%) @entity5 showed spliced @entity2215 transcripts, whereas 30 (24.2%) contained full-length @entity2215 transcripts. The presence of both spliced and full-length @entity2215 transcripts was significantly associated with @entity4180 amplification. @entity2215 in general showed no correlation to other prognostic factors, ie, International @entity521 Staging System stage, International @entity521 Pathology classification grade, or age at diagnosis, whereas the presence of full-length transcripts was significantly associated with higher stages. The presence of any @entity2215 transcripts carried no significant prognostic information, yet full-length @entity2215 transcripts were highly predictive of poor outcome (P < 0.0001). In a multivariate analysis, full-length @entity2215 transcripts and International @entity521 Pathology classification grade emerged as the sole independent predictors of event-free survival, with relative risks of 10.0 and 3.9, respectively. The strong statistical correlation of full-length @entity2215 transcripts with clinical outcome in @entity521 suggests that the reverse transcriptase-polymerase chain reaction analysis of @entity2215 transcripts may be equatable to TA measurements. Because this assay is well suited for archival material, it could become a useful adjunct in evaluating the prognosis of individual @entity521 cases.
