Detection of circulating tumor cells in men with localized prostate cancer.
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.
Seiden
M V
MV
Department of Pathology, Brigham and Women's Hospital, Boston, MA.
Kantoff
P W
PW
Krithivas
K
K
Propert
K
K
Bryant
M
M
Haltom
E
E
Gaynes
L
L
Kaplan
I
I
Bubley
G
G
DeWolf
W
W
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
D014408:Biomarkers, Tumor; D005819:Genetic Markers; D012333:RNA, Messenger; D017430:Prostate-Specific Antigen