The Role of PSA-mRNA RT-PCR in Molecular Staging of Prostate Cancer.
- Author:
Han CHUNG
1
;
Sang Hyeon CHEON
;
Choung Soo KIM
Author Information
1. Department of Urology, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Reverse transcriptase-polymerase chain reaction;
Prostate specific antigen
- MeSH:
DNA;
Humans;
Lymph Nodes;
Lymphocytes;
Male;
Molecular Biology;
Neoplasm Grading;
Prostate*;
Prostate-Specific Antigen;
Prostatectomy;
Prostatic Neoplasms*;
RNA;
RNA, Messenger;
Sample Size;
Tumor Burden
- From:Korean Journal of Urology
1999;40(9):1137-1144
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Recent studies report that up to 40 to 50% of patients who were thought to have clinically localized disease were found to be understaged subsequent to radical surgery. Clearly, development of more sensitive means to identify patients with micrometastatic, locally invasive disease is warranted. With the development of molecular biology, we can apply reverse transcriptase-polymerase chain reaction (RT-PCR) that allows us to identify PSA-synthesizing cells in peripheral blood even when they are highly diluted in a population of peripheral lymphocytes. In this study, we will evaluate the role of RT-PCR in molecular staging of prostate cancer to apply it to clinical situations. MATERIALS AND METHODS: Peripheral blood was obtained from a wide variety of patients with and without prostate cancer before radical prostatectomy. After ribonucleic acid isolation, complementary deoxyribonucleic acid was generated and amplified with a hot-start technique. RT-PCR results were compared with pathologic stage, Gleason score, serum PSA and tumor volume. RESULTS: The RT-PCR test was positive in 0 of 20 controls without suspicion of prostate cancer. Before radical prostatectomy a positive test was obtained in 2 of 9(22.2%) with pT2 disease versus 3 of 5(60%) with pT3 disease. A positive test was obtained in 5 of 6(83.3%) with overt lymph node or bone metastatic disease. We obtained intermittent RT-PCR positive results in serial procedures with two overt bone metastatic cancer patients. There was no significant difference in serum PSA, Gleason score or tumor volume between the men with positive or negative results. CONCLUSIONS: The PSA RT-PCR test in our laboratory cannot be used preoperatively to predict accurate pathological stage of prostate cancer who have undertaken radical prostatectomy. But there is a tendency that PSA mRNA was more frequently detected with higher stage. If the methodology of RT-PCR is refined and improved and sample size increased, RT-PCR for PSA mRNA will become a valuable tool for the evaluation of prostate cancer patients.
