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Immunohistochemical detection of telomerase reverse transcriptase (TERT) protein in benign and malignant tumor cells of the breast.

Telomerase activity is associated with immortality and is expressed in various malignant tumors. Telomerase reverse transcriptase (TERT) is a human telomerase catalytic subunit and is strongly correlated with telomerase activity. In this study, the expression of TERT was investigated by immunocytochemistry to determine whether it is a useful marker for differential diagnosis in benign or malignant breast tumors. We examined imprint smears prepared from 63 surgically resected breast lesions, and 27 cases of secretion or aspiration cytology smears had been routinely diagnosed. Eighteen of the 63 cases were examined for TERT mRNA and the correlation with expression of TERT protein was investigated. Expression of TERT protein was correlated with expression of TERT mRNA by in situ hybridization (p=0.044), suggesting that telomerase activity might be expressed with morphologic factors. In imprint smears and routine cytology smears, TERT-positive cases significantly tended to be malignant cases (p=0.014, p=0.033 respectively). Especially, in malignant imprint smear cases, positive expression of TERT was significantly correlated with lymph node metastasis (p=0.022). In conclusion, the expression of TERT protein might be a useful marker for differential diagnosis in malignant and benign breast tumors. In malignant cases, it could be a useful indicator for the assessment of potential of lymph node metastasis [corrected].