Although high-risk human papillomavirus (HPV) infection plays a major role in the development of cervical cancer, additive oncogenic events are involved as well. One key event involves increased activity of telomerase resulting from a deregulated expression of its catalytic subunit hTERT. Our previous microcell-mediated chromosome transfer studies revealed that introduction of human chromosome 6 in the HPV16-immortalized keratinocyte cell line FK16A and in the HPV16-containing cervical cancer cell line SiHa induced growth arrest, resulting from a repression of hTERT mRNA expression and telomerase activity. Here, this model was used to analyze expression profiles associated with hTERT deregulation in HPV-transformed cells. Microarray expression analysis of 12 FK16A/chromosome 6 hybrids, 4 of which were negative for endogenous hTERT and 8 of which were positive for endogenous hTERT, resulted in the identification of 164 differentially expressed genes. Differential expression of a selection of 5 genes was verified by real-time RT-PCR. Of these 164 genes, 32 were also differentially expressed in other HPV transformed cells with deregulated hTERT. For 2 of these genes, encoding AQP3 and MGP, altered expression in hTERT positive cervical carcinomas was confirmed by real-time RT-PCR and immunohistochemistry, respectively. Moreover, increased MGP protein expression was significantly more frequent in high-grade cervical premalignant lesions with elevated hTERT mRNA expression compared to those without. In summary, we identified 32 candidate biomarkers for deregulated hTERT mRNA expression, which may enable the identification of cervical premalignant lesions that are at highest risk to progress to invasive cancer. ' 2007 Wiley-Liss, Inc.Key words: HPV; hTERT; telomerase; cervical carcinogenesis; microarray expression analysis The main risk factor for the development of cervical cancer is infection with high-risk human papillomavirus (hrHPV), 1 which is supported by the detection of hrHPV in virtually all cervical carcinomas. 2 Cervical cancer evolves from preexisting noninvasive premalignant lesions referred to as cervical intraepithelial neoplasia (CIN), graded CIN1 to CIN3. Progression of an hrHPV infected CIN lesion to invasive cancer is a result of further specific (epi)genetic alterations within the host cell genome. 3,4 One of the consequences that is crucial for tumor development is an increased activity of telomerase. 5,6 Telomerase is a ribonucleoprotein that can elongate the chromosomal ends or telomeres, thereby compensating for telomere shortening that is inherent to DNA replication. 7 Whereas most cancer cells display elevated telomerase activity and stabilized telomeres, resulting in an unlimited lifespan, most primary somatic cells exhibit absence of detectable telomerase activity and continuous telomere erosion during cell division. The latter ultimately leads to the induction of senescence. 7 Telomerase consists of several subunits, including a structural RNA component (hTR) that serves as a template dur...