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 numberof 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 thepathogenesis of the disease from this region. Aim: The present study evaluated the role of differential expressionof human telomerase reverse transcriptase (hTERT) in the development of gall bladder anomalies. Materialsand
Methods: Blood and tissue samples were collected from patients undergoing routine surgical resection forclinically 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. Wholeblood was also collected from age and sex matched healthy controls (n=25) for comparative analysis. DifferentialhTERT mRNA expression was evaluated by semi-quantitative rt-PCR and real-time PCR based analysis usingβ-actin as an internal control. Evaluation of differential hTERT protein expression was studied by Western blotanalysis and immunoflourescence. Statistical analysis for differential expression and co-relation was performedby SPSSv13.0 software.
Results: Gallbladder anomalies were mostly prevalent in females. The hTERT mRNAand protein expression increased gradiently from normal<CL<CS<GBC cases. Serum expression correlatedstatistically significantly with the tissue based mRNA expression pattern of hTERT, with highest expressionobserved in GBC cases and the lowest expression in normal gall bladder.
Conclusions: Higher hTERT expressionis associated with gallbladder disease susceptibility and severity; and may be a useful prognostic marker forgallbladder anomalies.