Prognostic relevance of human telomerase reverse transcriptase (hTERT) expression in patients with gall bladder disease and carcinoma.

BACKGROUND

Gallbladder carcinoma (GBC) has been stated as an Indian disease, with the highest number of cases being reported from certain districts of northeast India, which has an ethnically distinct population. Unfortunately there are no scientific reports on the underlying molecular mechanisms associated with the pathogenesis of the disease from this region.

AIM: The present study evaluated the role of differential expression of human telomerase reverse transcriptase (hTERT) in the development of gall bladder anomalies.

MATERIALS AND

METHODS

Blood and tissue samples were collected from patients undergoing routine surgical resection for clinically proven cases of gallbladder disease {cholelithiasis (CL, n=50), cholecystitis (CS, n=40) and GBC (n=30) along with adjacent histopathologically proved non-neoplastic controls (n=15)} with informed consent. Whole blood was also collected from age and sex matched healthy controls (n=25) for comparative analysis. Differential hTERT mRNA expression was evaluated by semi-quantitative rt-PCR and real-time PCR based analysis using β-actin as an internal control. Evaluation of differential hTERT protein expression was studied by Western blot analysis and immunoflourescence. Statistical analysis for differential expression and co-relation was performed by SPSSv13.0 software.

RESULTS

Gallbladder anomalies were mostly prevalent in females. The hTERT mRNA and protein expression increased gradiently from normal<CL<CS<GBC cases. Serum expression correlated statistically significantly with the tissue based mRNA expression pattern of hTERT, with highest expression observed in GBC cases and the lowest expression in normal gall bladder.

CONCLUSIONS

Higher hTERT expression is associated with gallbladder disease susceptibility and severity; and may be a useful prognostic marker for gallbladder anomalies.