Telomerase reverse transcriptase expression is increased early in the Barrett's metaplasia, dysplasia, adenocarcinoma sequence

• Published in: Journal of gastrointestinal surgery 2000-03, Vol.4 (2), p.135-142
• Main Authors: Lord, Reginald V.N., Salonga, Dennis, Danenberg, Kathleen D., Peters, Jeffrey H., DeMeester, Tom R., Park, Ji Min, Johansson, Jan, Skinner, Kristin A., Chandrasoma, Para, DeMeester, Steven R., Bremner, Cedric G., Tsai, Peter I., Danenberg, Peter V.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - enzymology; Adenocarcinoma - genetics; Adenocarcinoma - pathology; Barrett Esophagus - enzymology; Barrett Esophagus - genetics; Barrett Esophagus - pathology; Barrett's esophagus; Cancer; Cell Transformation, Neoplastic; DNA Primers; DNA-Binding Proteins; esophageal adenocarcinoma; esophageal neoplasms; Esophageal Neoplasms - enzymology; Esophageal Neoplasms - genetics; Esophageal Neoplasms - pathology; Gene Expression Regulation, Neoplastic; hTERT; hTRT; Humans; Reverse Transcriptase Polymerase Chain Reaction; RNA; RNA, Messenger - analysis; RNA, Messenger - biosynthesis; Telomerase; Telomerase - genetics; Telomerase - metabolism; telomerase reverse transcriptase; telomere; Throat
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1016/S1091-255X(00)80049-9

Barrett's esophagus is a multistage polyclonal disease that is associated with the development of adenocarcinoma of the esophagus and esophagogastric junction. Telomerase activation is associated with cellular immortality and carcinogenesis, and increased expression of the telomerase reverse transcriptase catalytic subunit (hTERT) has been used for the early detection of malignant diseases. To identify biomarkers associated with each stage of the Barrett's process, relative mRNA expression levels of hTERT were measured using a quantitative reverse transcription—polymerase chain reaction method (ABI 7700 Sequence Detector (TaqMan system) in Barrett's intestinal metaplasia (n = 14), Barrett's dysplasia (n = 10), Barrett's adenocarcinoma (n = 14), and matching normal squamous esophagus tissues (n = 32). hTERT expression was significantly increased at all stages of Barrett's esophagus, including the intestinal metaplasia stage, compared to normal tissues from patients without cancer (intestinal metaplasia vs. normal esophagus, P 20) were found only in patients with cancer. These findings suggest that telomerase activation is an important early event in the development of Barrett's esophagus and esophageal adenocarcinoma, that very high telomerase levels may be a clinically useful biomarker for the detection of occult adenocarcinoma, and that a widespread cancer “field” effect is present in the esophagus of patients with Barrett's cancer.