title: Limitations of urinary telomerase activity measurement in urothelial cancer.
abstract: The reported frequency of detectable telomerase activity in spontaneously voided urine samples from patients with urothelial cancer varied from 0 to 85%. We examined stasis in the bladder and specimen storage as interfering conditions in this assay. Telomerase activity in exfoliated cells was measured by a polymerase-chain-reaction-based assay in spontaneously voided urine from urothelial cancer patients. Effects of retention in the bladder and specimen storage from voiding to measurement of telomerase activity were modeled by suspending 10(6) cells from the cancer-derived T24 line in normal urine (pH 6.5) at 37 degrees C and 25 degrees C, respectively. Hematuria was modeled by adding hemoglobin. In T24 cells suspended in urine at 37 degrees C, telomerase activity had decreased to approximately 20% of preincubation activity after 1 h, and had disappeared after 3 h. In urine at 25 degrees C, telomerase activity in T24 cells had decreased to approximately 40% of preincubation activity at 1 h and to <10% at 6 h. When we examined telomerase activity in exfoliated cells in spontaneously voided urine from urothelial cancer patients (excluding first-voided morning specimens), telomerase activity was detected in only 21% of samples (four of 19) despite measurement with 1 h of voiding and steps to avoid hemoglobin interference. Measurement of telomerase activity in spontaneously voided urine is insufficiently sensitive and reliable for the diagnosis of urothelial cancer.
authors.affiliation: Department of Laboratory Diagnosis, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: T
authors.initials: T
authors.lastname: Yajima
authors.forename: A
authors.initials: A
authors.lastname: Yagihashi
authors.forename: D
authors.initials: D
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Kameshima
authors.forename: M
authors.initials: M
authors.lastname: Sasaki
authors.forename: K
authors.initials: K
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Kuwajima
authors.forename: N
authors.initials: N
authors.lastname: Miyao
authors.forename: T
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: N
authors.initials: N
authors.lastname: Watanabe
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000201:enzymology* / Q000473:pathology; D004355:Drug Stability; D006417:Hematuria / Q000201:enzymology; D006801:Humans; D016133:Polymerase Chain Reaction; D012091:Repetitive Sequences, Nucleic Acid; D012680:Sensitivity and Specificity; D019098:Telomerase / Q000652:urine*; D016615:Telomere; D014407:Tumor Cells, Cultured; D001749:Urinary Bladder Neoplasms / Q000201:enzymology* / Q000473:pathology; D016055:Urinary Retention / Q000201:enzymology; D014556:Urine / Q000166:cytology
chemical_list: D019098:Telomerase