Prognostic value of combined "triple"-reverse transcription-PCR analysis for prostate-specific antigen, human kallikrein 2, and prostate-specific membrane antigen mRNA in peripheral blood and lymph nodes of prostate cancer patients.
OBJECTIVE
We present the largest study of both peripheral blood and lymph node samples examining the utility of reverse transcription-polymerase chain reaction (RT-PCR) for established molecular markers as a diagnostic tool in the molecular staging of prostate cancer patients undergoing radical prostatectomy.


METHODS
Peripheral blood from 358 patients was obtained before radical prostatectomy. Corresponding obturatory lymph node samples were collected from 153 of these patients. Nested RT-PCR for prostate-specific antigen (PSA), human kallikrein 2 (hK2), and prostate-specific membrane antigen (PSMA) were performed on cDNA from peripheral blood. The lymph node cDNA was analyzed for PSA und hK2 expression.


RESULTS
RT-PCR in peripheral blood was positive in 124 (34.6%) of 358 samples for PSA, 215 (60.1%) of 358 for PSMA, and 97 (27.1%) of 358 for hK2. Comparison of positive RT-PCR rates of pT(2) and pT(3) tumors in corresponding peripheral blood for PSA, PSMA, and hK2 were 31.9 and 40.0%, 58.8 and 62.5%, and 26.9 and 27.5%, respectively. Histopathologically, cancer-free lymph node samples were positive in RT-PCR for PSA and hK2 in 70 (49.6%) of 141 and 89 (63.2%) of 141 of cases. All histologically positive lymph node samples (n = 12, pN+) were positive for PSA RT-PCR. PSA RT-PCR alone, as well as combined PSA/PSMA RT-PCR evaluation, in peripheral blood showed a significant association with grading. PSA RT-PCR lymph node-negative samples were significantly less likely positive in their corresponding peripheral blood RT-PCR sample.


CONCLUSIONS
Although the preoperative PSA RT-PCR in peripheral blood correlated with the grading of prostate cancer, no combination of RT-PCR results using "triple" markers (PSA, hK2, PSMA) in peripheral blood and/or lymph nodes yielded additional preoperative staging information.
Kurek
Ralf
R
Department of Anatomy and Cell Biology, Philipps-University, Marburg, Germany. rkurek@gmx.de
Nunez
German
G
Tselis
Nikolaos
N
Konrad
Lutz
L
Martin
Thomas
T
Roeddiger
Sandra
S
Aumüller
Gerd
G
Zamboglou
Nikolaos
N
Lin
Daniel W
DW
Tunn
Ulf W
UW
Renneberg
Heiner
H
D000954:Antigens, Surface / Q000097:blood / Q000235:genetics*; D016022:Case-Control Studies; D018076:DNA, Complementary / Q000235:genetics; D043425:Glutamate Carboxypeptidase II / Q000097:blood / Q000235:genetics*; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000378:metabolism; D017430:Prostate-Specific Antigen / Q000097:blood / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000097:blood / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D020840:Tissue Kallikreins / Q000097:blood / Q000235:genetics*; D014407:Tumor Cells, Cultured
D000954:Antigens, Surface; D018076:DNA, Complementary; D012333:RNA, Messenger; D012334:RNA, Neoplasm; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D020840:Tissue Kallikreins; D017430:Prostate-Specific Antigen