Li-Jie Ma, from Fudan University in Shanghai, and colleagues used telomere-specific fluorescence in situ hybridization and quantitative polymerase chain reaction to assess telomere length in HCC cell lines, tumor tissues, and nontumor cells within the tumor.
The researchers found that, compared with their normal counterparts, significant telomere attrition was found in tumor cells and cancer-associated fibroblasts (CAFs), but not in intratumor leukocytes or bile duct epithelial cells. On tissue microarrays of 257 surgically treated HCC patients, reduced intensity of telomere signals in tumor cells or CAFs were associated with larger tumor size and presence of vascular invasion (P < 0.05). There was a correlation for shortened telomeres in tumor cells or CAFs with reduced survival and increased recurrence, and they were independently prognostic for HCC patients (P < 0.05). The findings were validated in a cohort of 371 HCC patients from The Cancer Genome Atlas database. There was a correlation for telomerase reverse transcriptase promoter mutation with telomere shortening in HCC.
“Telomere variation in tumor cells and non-tumor cells within the tumor microenvironment of HCC was a valuable prognostic biomarker for this fatal malignancy,” the authors write.