title: Prognostic significance of detection of prostate-specific antigen transcripts in the peripheral blood of patients with metastatic androgen-independent prostatic carcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic significance of reverse transcriptase polymerase chain reaction (RT PCR) detection of prostate-specific antigen (PSA) mRNA in relation to survival in patients with metastatic androgen-independent prostatic carcinoma (AIPC).
  
  
  METHODS
  Peripheral blood from 122 men (64 from Memorial Sloan-Kettering Cancer Center [MSKCC] and 58 from the Dana Farber Cancer Institute [DFCI]) with metastatic (Stage D2) AIPC was analyzed for PSA mRNA using RT PCR. Forty-one controls without prostatic carcinoma were also evaluated.
  
  
  RESULTS
  RT PCR positivity for PSA mRNA was present in 24 of the 64 (38%) patients seen at MSKCC and in 26 of the 58 (45%) patients followed at DFCI. All control individuals were PSA PCR negative. There was a significant correlation between RT PCR positivity and decreased survival in each of the Memorial and Dana Farber population (P = 0.028 and 0.039, respectively). Serum PSA (at time of blood collection for PCR) was not predictive of survival as a continuous variable in the MSKCC [P = 0.31] and the DFCI (P = 0.09) groups. RT PCR for PSA mRNA was found to be independent from and superior to serum PSA in predicting survival in both the MSKCC and DFCI populations (P = 0.048 and P = 0.027, respectively).
  
  
  CONCLUSIONS
  The detection of PSA mRNA in the peripheral blood by RT PCR is a predictor of survival in patients with metastatic AIPC, and PCR is superior to a single serum PSA measurement. Further studies are needed to test the value of this factor in comparison to and coupled with other prognostic parameters.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Ghossein
authors.forename: J
authors.initials: J
authors.lastname: Rosai
authors.forename: H I
authors.initials: HI
authors.lastname: Scher
authors.forename: M
authors.initials: M
authors.lastname: Seiden
authors.forename: Z F
authors.initials: ZF
authors.lastname: Zhang
authors.forename: M
authors.initials: M
authors.lastname: Sun
authors.forename: G
authors.initials: G
authors.lastname: Chang
authors.forename: K
authors.initials: K
authors.lastname: Berlane
authors.forename: K
authors.initials: K
authors.lastname: Krithivas
authors.forename: P W
authors.initials: PW
authors.lastname: Kantoff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D016133:Polymerase Chain Reaction; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D012333:RNA, Messenger / Q000032:analysis; D015996:Survival Rate; D013739:Testosterone / Q000097:blood
chemical_list: D012333:RNA, Messenger; D013739:Testosterone; D017430:Prostate-Specific Antigen