title: Detection of circulating tumor cells in men with localized prostate cancer.
abstract: OBJECTIVE
  Using prostate-specific antigen (PSA) mRNA as a marker for prostatic epithelial cells, we have developed a sensitive technique that involves reverse transcription and polymerase chain reaction (RT-PCR) to detect circulating tumor cells in the peripheral blood of men with prostatic carcinoma (CaP).
  
  
  METHODS
  A sensitive RT-PCR assay was used to evaluate the peripheral blood of 135 men with a history of CaP. Fourteen men with benign prostate disease, many of whom had elevated serum PSA levels, were used as a control group.
  
  
  RESULTS
  All patients with benign prostate disease had a negative result in the RT-PCR assay. Of particular interest was a subgroup of 65 patients with clinically localized CaP evaluated before definitive local therapy. Five of these patients had detectable PSA mRNA by RT-PCR, suggesting circulating tumor cells. Within this group, systemic disease was detected by RT-PCR in some men with PSA levels less than 10 ng/mL and clinical stage B disease. Blood from men with hormone-refractory and progressive CaP demonstrated a higher frequency of PSA mRNA detectable by RT-PCR (10 of 20 patients). In contrast, none of seven patients with newly diagnosed metastatic prostate cancer and only one of seven patients with metastatic, hormone-responsive disease had blood that was positive for PSA mRNA by RT-PCR.
  
  
  CONCLUSIONS
  Circulating tumor cells can be detected in the blood of a subset of patients with clinically localized CaP and a larger subset of patients with progressive metastatic disease.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Boston, MA.
authors.forename: M V
authors.initials: MV
authors.lastname: Seiden
authors.forename: P W
authors.initials: PW
authors.lastname: Kantoff
authors.forename: K
authors.initials: K
authors.lastname: Krithivas
authors.forename: K
authors.initials: K
authors.lastname: Propert
authors.forename: M
authors.initials: M
authors.lastname: Bryant
authors.forename: E
authors.initials: E
authors.lastname: Haltom
authors.forename: L
authors.initials: L
authors.lastname: Gaynes
authors.forename: I
authors.initials: I
authors.lastname: Kaplan
authors.forename: G
authors.initials: G
authors.lastname: Bubley
authors.forename: W
authors.initials: W
authors.lastname: DeWolf
mesh_terms: D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000097:blood*; D005819:Genetic Markers; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012333:RNA, Messenger / Q000097:blood*; D012680:Sensitivity and Specificity; D014158:Transcription, Genetic
chemical_list: D014408:Biomarkers, Tumor; D005819:Genetic Markers; D012333:RNA, Messenger; D017430:Prostate-Specific Antigen