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Re: Poremba et al Telomerase as a prognostic marker in breast cancer: high‐throughput tissue microarray analysis of hTERT and hTR. J Pathol 2002; 198: 181–189

We read with great interest the article by Poremba et al [1] in which the authors observed that hTERT protein expression by immunohistochemistry (IHC) was an independent prognostic indicator in patients with breast cancer. We have recently used reverse transcriptase-polymerase chain reaction (RT-PCR) and Taqman methodology to determine hTERT mRNA expression in 122 breast specimens (unpublished data). We have confirmed that hTERT mRNA expression is significantly higher in invasive breast cancer than in benign or normal breast tissue (p < 0.0001), suggesting that this component has a potential role in complementing the pathological diagnosis of breast cancer. We have also found that hTERT mRNA expression correlates with telomerase activity in human breast cancer (rs = 0.51112, p = 0.0302). Furthermore, we observed that high hTERT mRNA expression was significantly associated with the absence of progesterone receptors in breast cancer specimens but not with tumour stage or other prognostic parameters. We previously reported a significant association between telomerase activity and established prognostic predictors such as tumour size, lymph node metastasis, and lymphovascular invasion [2–5]. The lack of a statistically significant relationship between hTERT mRNA and tumour stage in our study can be attributed to the presence of hTERT splice variants, which in itself can explain the absence of a strong correlation with telomerase activity. This limitation is largely overcome by measuring hTERT protein expression by immunohistochemistry in Poremba et al’s study [1]. We have been searching for a reliable anti-hTERT antibody for immunohistochemical measurement for several years and we greatly welcome the development of the human anti-telomerase antibody Ab-2 by Calbiochem. This represents a significant advance that opens new research avenues regarding the clinical use of hTERT as a diagnostic, therapeutic and prognostic marker.