Telomerase expression and p53 status in hepatocellular carcinoma

OBJECTIVES: Genomic instability is a driving force for tumorigenesis. Telomerase and p53 play central roles in maintaining genomic integrity. The purpose of this study was to assess the role of telomerase expression and p53 protein overexpression in hepatocellular carcinoma (HCC). METHODS: Telomerase activity and p53 overexpression were investigated in 63 patients undergoing hepatectomy for HCC by a telomeric repeat amplification protocol and immunohistochemistry, respectively. The associations among telomerase expression, p53 overexpression, and clinicopathological features were analyzed, and independent prognostic factors in the recurrence of HCC after hepatectomy were determined. RESULTS: Telomerase expression did not correlate with clinicopathological features except hepatitis virus status (p = 0.04) and was identified as a significant prognostic variable for HCC recurrence (p = 0.027) along with portal venous invasion (p = 0.001). In contrast, p53 overexpression strongly correlated with tumor differentiation (p < 0.0001) but did not reflect time to recurrence (p = 0.26). Telomerase expression did not correlate with p53 overexpression (p = 0.35). CONCLUSIONS: The reactivation of telomerase was of significant value in predicting the recurrence of HCC after hepatectomy. However, p53 overexpression did not correlate with telomerase expression in HCC, nor did it reflect the time to recurrence. (C) 2002 by Am. Coll. of Gastroenterology.