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Detection of hTERT mRNA in Colonic Brush Specimens as an Adjunct to Cytopathologic Diagnosis of Colonic Adenocarcinoma.
Acta cytologica
  • Zong-Mei Sheng, MD
  • YuJing Baili
  • Yener S Erozan, MD, FIAC
  • Timothy J O'Leary, MD, PhD
  • Sherry Li, MD, Lehigh Valley Health Network
Publication/Presentation Date
OBJECTIVE: To investigate the role of reverse transcriptase polymerase chain reaction (RT-PCR) in determining telomerase catalytic subunit (hTERT) mRNA to assist with the diagnosis of colonic adenocarcinoma (CCA) in colonic brush cytology specimens. STUDY DESIGN: Twenty-seven colonic brushes of CCA were obtained. Initial cytologic diagnoses included CCA, suspicious for CCA (SFC), atypical (ATY) and unsatisfactory. The cytologic specimens were reviewed. A homogeneous RT-PCR assay for hTERT mRNA was performed on 27 colonic brushes of CCA and 24 controls (10 negative brushes, 6 resected CCA and 8 benign colonic mucosa from resected specimens). A RT-PCR assay for beta 2-microglobulin was used as an internal control for mRNA quality. RESULTS: On review, the initial cytopathologic diagnosis of CCA was confirmed in all 7 cases. In addition, 7 of 19 initially interpreted as SFC and ATY seemed to demonstrate unequivocal cytomorphologic features of malignancy. Telomerase mRNA was more often expressed in CCA than in negative controls in both brush (30%) and resected specimens (57%) (P < .05). Seven cases with hTERT mRNA expression were initially diagnosed as CCA (three), SFC (three) and ATY (one). CONCLUSION: CCA may be underdiagnosed in brush cytopathology. The expression of hTERT mRNA may be determined by RT-PCR in brush specimens and may eventually prove to be a useful diagnostic adjunct in the interpretation of inconclusive cases of CCA. Sparse cellularity in brush specimens may result in a relatively low rate of hTERT detection in colonic brushes of CCA; inflammatory changes may contribute to a higher-than-expected rate of hTERT expression in benign colonic epithelium.
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Citation Information

Li, S. Q., Sheng, Z., Baili, Y., Erozan, Y. S., & O'Leary, T. J. (2002). Detection of hTERT mRNA in colonic brush specimens as an adjunct to cytopathologic diagnosis of colonic adenocarcinoma. Acta Cytologica, 46(6), 1069-1074.