Telomerase Reverse Transcriptase protein expression as prognostic factor

Abstract

Introduction: Glioblastoma (GBM) is the most common malignant primary tumor of the central nervous system in the adult male. The average survival is between 3 and 5 months without treatment, and between 9 and 15 months with surgical resection accompanied by chemotherapy and radiotherapy. Discovering accurate prognostic markers is important for finding the optimal treatment strategy for each patient diagnosed with GBM. Objectives: Evaluate the correlation between the expression of Telomerase Reverse Transcriptase protein (TERT), the magnitude of peritumoral cerebral edema and outcome in patients to identify a possible prognostic factor for GBM. Methodology: Patients treated by the neurosurgery department of Hospital Santa Paula, São Paulo, Brazil, between 2010 and 2018 with a diagnosis of glioblastomas were selected. The patient data was collected from the patient journals. The size of the peritumoral cerebral edema was classified from the magnetic resonance. The tissue-samples were collected after the surgery, and were submitted to a histological and immunohistochemical analysis to evaluate the level of protein and gene expression of TERT. Due to the limited samples only descriptive statistics was used. Results: Out of the 12 patients, 4 had a positive protein expression of TERT and the older patients generally showed a lower expression. Of the 5 deceased patients, all but one had major edema, and none showed any expression of TERT protein. In addition, all the patients with GBMs found in the parietal lobe died. Discussion: Lower levels of TERT may be related to advanced age. GBMs located in the parietal lobe may be more aggressive. There was a direct positive relationship between death and peritumoral edema, as well as a negative relationship between death and TERT protein expression, but the sample was too low for statistical significance to these conclusions.