The role of combined measurement of tissue mRNA levels of AMACR and survivin in the diagnosis and risk stratification of patients with suspected prostate cancer.
OBJECTIVE
To determine whether the measurement of tissue mRNA levels of AMACR and survivin has a role in distinguishing prostate cancer (PCa) from benign lesions and high risk from low-risk PCa in men with suspected PCa.


METHODS
TRUS prostate biopsies from 170 patients with suspected PCa were used to measure the mRNA levels of AMACR and survivin using semi-quantitative RT-PCR technique. The diagnosis, staging and risk stratification of PCa was based on established clinical criteria. The ability of tissue mRNA levels to distinguish benign from malignant prostate and high- and low-risk PCa was assessed. The diagnostic value for the two genes was evaluated by calculating their individual and combined sensitivity and specificity, which were compared with that of PSA.


RESULTS
Histological examination showed 90/170 (53%) of patients had benign prostate pathology, while 80/170 (47%) had PCa. Tissue mRNA levels of both AMACR and survivin were able to distinguish benign from PCa biopsies (p<0.0001) and also high-risk from low-risk PCa cases (p<0.02, p<0.05, respectively). Compared with serum PSA levels, the combined use of tissue mRNA levels of AMACR and survivin yielded a higher detection specificity (84 vs. 22%).


CONCLUSIONS
Based on AMACR and survivin combined sensitivity and specificity, these mRNA markers can be used as an adjunct to distinguish patients with and without PCa and in men with PCa may help to identify those with low- or high-risk PCa.
Department of Biochemistry, Faculty of Medicine, Kuwait University, Safat, Kuwait.
May
M
Al-Maghrebi
Elijah O
EO
Kehinde
Jehoram T
JT
Anim
Mehraj
M
Sheikh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000737:chemistry* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000737:chemistry* / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D012333:RNA, Messenger / Q000032:analysis*; D019998:Racemases and Epimerases / Q000235:genetics*; D018570:Risk Assessment / Q000379:methods; D000077022:Survivin
C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D012333:RNA, Messenger; D000077022:Survivin; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase