Telomere length distinguish benign and malignant lesions with overlapping morphology.

What is it about?

Inverted papilloma of the bladder is a rare benign tumor. Sometimes, the tumor will morphologically mimic inverted urothelial carcinoma. Traditional light microscopic observation methods hard to differentiate the benign and malignant. Telomere is the DNA structure located at each end of human chromosomes to prevent DNA strands from degradation and joining with other sequence. Telomeres shorten with each round of cell division and work as count down timer to limit proliferation of human cells to a finite number of cell divisions. When telomere is critically short, the cell dies. Telomere shortening is considered an early event in the development of cancers in many organs. The telomere length could be measured by fluorescence in situ hybridization with telomere specific DNA nucleotide. In this study, we evaluated telomere length in 77 bladder lesions showing overlapping morphology to explore the possibility to differentiate the malignant lesions from benign lesions. Set telomere length as 100%, the relative telomere lengths of malignant (inverted carcinoma), proliferate lesions (glandularis) and benign tumor (inverted papilloma) were 29%, 84% and 91%, respectively. Telomere length analysis could potentially a useful biomarker to distinguish benign and malignant lesions with overlapping morphology.

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Why is it important?

Some of the benign and malignant lesions in the bladder have overlapping look and could be challenging to differentiate. Telomere length in fast growthing cells will be progressively shortening, which could be used as a biomarker to do the differential diagnosis.

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