title: Detection of pelvic lymph node micrometastasis by real-time reverse transcriptase polymerase chain reaction in prostate cancer patients after hormonal therapy.
abstract: OBJECTIVE
  To determine the feasibility of prostatic-specific antigen (PSA) mRNA and prostatic-specific membrane antigen (PSMA) mRNA measurement in detection of pelvic lymph node (PLN) micrometastasis for prostate cancer (PCa) after hormonal therapy (HT).
  
  
  METHODS
  Fifty-four patients diagnosed as high risk localized PCa were given HT for 3 months before radical prostatectomy. Under bipedal lymphangiography, a needle was punctured into involved lymph nodes (LN) and aspirated lymphatic fluid was obtained preoperatively. The expression of PSA mRNA and PSMA mRNA in aspirated fluid was assessed by a fully quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) and also in LN specimens from pelvic lymphadenectomy during prostatectomy.
  
  
  RESULTS
  Median follow-up was 36 months (range 18-58 months). Without histological evidence of PLN metastasis, twelve patients showed positive PSA and/or PSMA mRNA expressions and regarded as having micrometastases to PLNs. Biochemical recurrence (BCR) rate and interval between prostatectomy and BCR in patients with micrometastases (group B) were not significantly different to histologically proven PLN metastatic patients (group A) (58.3 vs. 83.3 %, P = 0.26; 10.9 vs. 9.2 months, P = 0.29, respectively), but significantly different to those with no PLN involvement (group C) (58.3 vs. 11.1 %, P = 0.002; 10.9 vs. 21.3 months, P < 0.001, respectively). Kaplan-Meier analysis showed both groups A and B had significantly lower non-BCR rate than group C (P < 0.001, P < 0.001, respectively).
  
  
  CONCLUSIONS
  For PCa patients receiving HT, measurement of PSA mRNA and PSMA mRNA in aspirated PLN fluid by real-time RT-PCR could effectively detect PLN micrometastases without surgical intervention.
authors.affiliation: Department of Urology, Shanghai Punan Hospital, Shanghai, People's Republic of China.
authors.forename: Ding-Yi
authors.initials: DY
authors.lastname: Liu
authors.forename: Wei-Mu
authors.initials: WM
authors.lastname: Xia
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Min-Wei
authors.initials: MW
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Shu-Jun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Yong-Feng
authors.initials: YF
authors.lastname: Ye
authors.forename: Wen-Long
authors.initials: WL
authors.lastname: Zhou
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shao
mesh_terms: D000368:Aged; D000954:Antigens, Surface / Q000235:genetics*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics*; D005500:Follow-Up Studies; D043425:Glutamate Carboxypeptidase II / Q000235:genetics*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D000954:Antigens, Surface; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D012333:RNA, Messenger; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen