Real time quantification in plasma of human telomerase reverse transcriptase (hTERT) mRNA in patients with colorectal cancer

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Abstract
Background Increased telomerase activity can be found in almost 90% of colorectal tumours. We aim to describe the preliminary results for quantification in plasma of hTERT mRNA in colorectal cancer patients. Materials and methods Fifty patients undergoing surgery for colorectal cancer and a control group of 50 healthy volunteers were prospectively studied. Pre‐operative venous blood samples were taken from all cancer patients and volunteers. Plasma hTERT expression was determined from peripheral blood based on real‐time quantitative RT‐PCR (qRT‐PCR) method normalized to the amount of RNA input using 18S rRNA gene expression. Plasma pre‐operative CEA levels were also determined. Results Median values for normalized hTERT (hTERTN) gene expression were higher in colorectal cancer patients (11.62, range 0.23–47.67) than healthy volunteers (0.29, range 0.00–4.63) (P < 0.001). Individual data showed that 82% of colorectal cancer patients had hTERTN expression values superior to the maximum value observed in the control group. Sensitivity and specificity of the assay for colorectal cancer detection were 98% and 64%, respectively. No significant differences in hTERTN expression between gender or with age (P > 0.05). No significant correlation was found between hTERTN expression and CEA values (Spearman's rank test = 0.136, P = 0.348). Conclusions These results show that detection of mRNA based on the qRT‐PCR of the telomerase hTERTN gene in plasma clearly differentiates between healthy and colorectal cancer patients and that hTERTN can be detected and quantified in plasma. This opens up a new field as a noninvasive blood test for colorectal cancer diagnosis.