Article

Distribution and prognostic significance of human telomerase reverse transcriptase (hTERT) expression in giant-cell tumor of bone.

Department of Pathology, University of California, 1600 Divisadero Drive B220, San Francisco, CA 94115-1656, USA.
Modern Pathology (Impact Factor: 6.36). 05/2008; 21(4):423-30. DOI: 10.1038/modpathol.3801015
Source: PubMed

ABSTRACT Giant-cell tumor of bone is considered a benign, locally aggressive and rarely metastasizing neoplasm of bone. Specific microscopic or radiographic findings that reliably predict behavior have remained elusive. However, recent evidence suggests that activity of the telomerase enzyme complex correlates with recurrence in giant-cell tumor, although the subset of cells with telomerase activity in these heterogeneous tumors has not been defined. In the present study, we investigated whether immunostaining for human telomerase reverse transcriptase, a component of the telomerase complex, correlates with outcome in giant-cell tumor and the distribution of telomerase reverse transcriptase staining in these tumors. We analyzed 58 cases of giant-cell tumor for the presence and pattern of telomerase reverse transcriptase immunostaining, presence of soft tissue involvement and the type of initial surgery, and correlated these findings with recurrence-free survival and metastasis-free survival. Specific staining with telomerase reverse transcriptase was present in 20 out of 58 tumors (35%) in the nuclei of mononuclear cells and, occasionally, osteoclast-like giant cells. Furthermore, positive telomerase reverse transcriptase immunohistochemistry correlated with recurrence-free survival (P=0.02), whereas the presence of soft tissue extension (P=0.3) and the type of initial surgery (P=0.2) did not. Only soft-tissue extension significantly correlated with metastasis-free survival (P=0.003). Therefore, telomerase reverse transcriptase expression may predict recurrence in giant-cell tumor insofar as positive immunostaining correlates with shorter recurrence-free survival and may be a useful prognostic marker to stratify patients to more aggressive treatment protocols.

0 Followers
 · 
105 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Platelet-derived growth factor-alpha receptor (PDGFRA) and c-kit are tyrosine kinase receptors expressed in many neoplasms. We investigated protein expression in 34 giant cell tumours of bone and two specimens of lung metastases. The expression of PDGFRA and c-kit was analysed by immunohistochemistry. Additionally, capillary sequencing of genomic DNA was performed to search for mutations in therapeutically relevant exons 12 and 18 of the PDGFRA gene and exons 9 and 11 of the c-kit gene. PDGFRA expression was detected in all specimens and all cellular components such as reactive osteoclast-like giant cells and neoplastic stromal cells. C-kit expression was found in six cases of giant cell tumour and one specimen of lung metastasis in all cellular components ranging from 5 to 50% (mean 4.8%, SD 12.4). A further 13 cases showed labelling of osteoclast-like giant cells. DNA sequence of exons 12 and 18 of the PDGFRA gene and exons 9 and 11 of the c-kit gene were not altered in these tumours. PDGFRA and c-kit play a functional role in the growth of giant cell tumours of bone but genetic changes of therapeutically relevant exons of the PDGFRA gene and the c-kit gene are not seen in these tumours.
    Pathology 12/2009; 41(7):630-3. DOI:10.3109/00313020903257749
  • [Show abstract] [Hide abstract]
    ABSTRACT: The telomeric checkpoint is emerging as a critical sensor of cellular damage, playing a major role in human aging and cancer development. In the meantime, telomere biology is rapidly evolving from a basic discipline to a translational branch, capable of providing major hints for biomarker development, risk assessment and targeted treatment of cancer. These advances have a number of implications in the biology of lymphoid tumours. Moreover, there is considerable interest in the potential role of telomeric dysfunction in the wide array of immunological abnormalities, grouped under the definition of 'immunosenescence'. This review will summarize the impact of recent advances in telomere biology on the physiology and pathology of the B lymphocyte, with special interest in immunosenescence and lymphomagenesis.
    Hematological Oncology 12/2010; 28(4):157-67. DOI:10.1002/hon.937
  • [Show abstract] [Hide abstract]
    ABSTRACT: Epidermal growth factor receptor (EGFR) is implicated in bone remodelling. The aim was to determine whether EGFR protein expression contributes to the aggressiveness and recurrence potential of giant cell tumour of bone (GCTB), an osteolytic primary bone tumour that can exhibit markedly variable clinical behaviour. Immunohistochemical analysis on tissue microarrays (TMA) of 231 primary, 97 recurrent, 17 metastatic and 26 malignant GCTBs was performed using TMA analysis software and whole digital slides allowing validated scoring. EGFR expression was restricted to neoplastic stromal cells and was significantly more frequent in recurrent (71 of 92; 77%) than in non-recurrent GCTBs (86 of 162; 53%) (P = 0.002); and in clinicoradiologically aggressive (31 of 43; 72%) than latent (27 of 54; 50%) cases (P = 0.034). Detecting phosphotyrosine epitopes pY1068 and -pY1173 indicated active EGFR signalling, and finding EGFR ligands EGF and transforming growth factor-α restricted to cells of the monocytic lineage suggested paracrine EGFR activation in stromal cells. In functional studies EGF supported proliferation of GCTB stromal cells, and the addition of EGF and macrophage-colony stimulating factor promoted osteoclastogenesis. In GCTB, EGFR signalling in neoplastic stromal cells may contribute to disease progression through promoting stromal cell proliferation and osteoclastogenesis.
    Histopathology 09/2011; 59(3):376-89. DOI:10.1111/j.1365-2559.2011.03948.x
Show more