title: Detection and characteristics of primary circulating prostate cells; association with micrometastasis and implications for surgical treatment of men with prostate cancer.
abstract: OBJECTIVE
  To determine the frequency of primary circulating prostate cells in men with prostate cancer at the time of diagnosis, the association with micrometastasis, sub-classification for CD82 and the relation with pathological stage. To determine their clinical usefulness to identify patients in whom radical prostatectomy would be first choice therapy.
  
  
  METHODS
  Men with the diagnosis of prostate cancer before definitive therapy. Blood and bone marrow samples were taken, mononuclear cells separated by differential centrifugation and prostate cells identified with immunocytochemistry using anti-PSA. Positive samples were sub-classified with anti-CD82. Details of serum PSA, Gleason score and pathological stage were registered.
  
  
  RESULTS
  Of 77 men 58 (75.3%) had primary CPCs detected, there was an association with stage but not Gleason. 31 (40.3%) had micrometastasis with an association with stage and Gleason score. CPC-negative patients had fewer micrometastasis detected, 1/19 versus 30/58 (p<0.003). There was an inverse relation between CD82 expression and Gleason score, men with CPCs expressing CD82 had fewer micrometastasis. The combined group of CPC negative and CPC positive CD82 positive men showed a sensitivity of 87%and specificity of 73.9% for the absence of micrometastasis.
  
  
  CONCLUSIONS
  The detection of CPCs and sub-classification with CD82 could be clinically useful to identify men with a significantly lower risk of micrometastais and as a consequence to identify men in whom radical prostatectomy could be the best initial treatment.
authors.affiliation: Hospital de Carabineros de Chile, Santiago de Chile. nigelpetermurray@gmail.com <nigelpetermurray@gmail.com>
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Murray
authors.forename: Eduardo
authors.initials: E
authors.lastname: Reyes
authors.forename: Leonardo
authors.initials: L
authors.lastname: Badínez
authors.forename: Nelson
authors.initials: N
authors.lastname: Orellana
authors.forename: Ricardo
authors.initials: R
authors.lastname: Dueñas
authors.forename: Cinthia
authors.initials: C
authors.lastname: Fuentealba
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D009360:Neoplastic Cells, Circulating; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*