Value of reverse transcription polymerase chain reaction assay in pathological stage T3N0 prostate cancer.
BACKGROUND
We tested the ability of the nested reverse transcription polymerase chain reaction (RT-PCR) assay to detect signs of biochemical recurrence of prostate cancer in the lymph nodes and peripheral blood of patients with pT3N0 prostate cancer.


METHODS
Using lymph nodes and pre- and postoperative peripheral blood dissected from 30 patients with pT3N0 prostate cancer treated by radical prostatectomy, we used RT-PCR for prostate-specific membrane antigen (PSM) and serum prostate-specific antigen (PSA) to determine the presence of prostate cancer. Results of the nested RT-PCR assay were compared with pathological stages and biochemical recurrence.


RESULTS
Two of 13 patients with capsular penetration (15%), 6 of 10 patients with invasion of seminal vesicles (60%), and 3 of 7 patients with a positive surgical margin (43%) were RT-PCR-positive for PSM and/or PSA in the lymph nodes. Results of preoperative RT-PCRs of peripheral blood for PSM and for PSA significantly differed between positive and negative results of RT-PCR in lymph nodes (P < 0.001 and P < 0.001, respectively). Results of postoperative RT-PCRs of peripheral blood for PSM and for PSA also significantly different between positive and negative results of RT-PCR in lymph nodes (P = 0.011 and P = 0.001, respectively). Nine of 11 patients with positive nested RT-PCR for PSM and/or PSA in the lymph nodes (82%) experienced biochemical recurrence. Significant difference in Kaplan-Meier recurrence-free actuarial curves was noted between patients who nested positive and negative on RT-PCR in the lymph nodes, pre- and postoperative peripheral blood, biopsy and prostatectomy Gleason score, and preoperative PSA values. In multivariate analysis, biopsy and prostatectomy Gleason score (P = 0.026, P = 0.020, respectively), pre- and postoperative RT-PCR for PSM in peripheral blood (P = 0.030 and P = 0.040, respectively), and RT-PCR for PSM in lymph nodes (P = 0.035) were independent prognostic factors.


CONCLUSIONS
Nested RT-PCR assay of the lymph nodes or peripheral blood significantly predicted biochemical recurrence after surgery. It may help identify patients at risk for recurrence and progression of prostate cancer.
Okegawa
T
T
Department of Urology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
Noda
H
H
Kato
M
M
Miyata
A
A
Nutahara
K
K
Higashihara
E
E
D000368:Aged; D000954:Antigens, Surface; D001707:Biopsy, Needle; D002268:Carboxypeptidases / Q000032:analysis* / Q000097:blood / Q000235:genetics; D004273:DNA, Neoplasm / Q000737:chemistry; D004587:Electrophoresis, Agar Gel; D005500:Follow-Up Studies; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis / Q000473:pathology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011467:Prostate / Q000737:chemistry / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis* / Q000097:blood / Q000235:genetics; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology*; D012334:RNA, Neoplasm / Q000737:chemistry / Q000302:isolation & purification; D012044:Regression Analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA
D000954:Antigens, Surface; D004273:DNA, Neoplasm; D012334:RNA, Neoplasm; D002268:Carboxypeptidases; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen