title: PCA3 and PSA gene activity correlates with the true tumor cell burden in prostate cancer lymph node metastases.
abstract: BACKGROUND
  Extent of pelvic lymph node (LN) dissemination is a critical prognostic feature for patients with prostate cancer (PCa) maintaining extended pelvic lymphadenectomy (LAD) as the gold standard for LN-staging. Unfortunately, conventional histopathological assessment may miss micrometastasis and recently presented immunocytochemical approach of the single cell analysis is still intricate.
  
  
  OBJECTIVE
  To comparatively assess the potential of Prostate cancer gene 3 (PCA3) and prostate specific antigene (PSA) to perform as markers for tumor cell load.
  
  
  METHODS
  Patients with high risk PCa for LN metastasis undergoing either a sentinel LN-guided staging LAD or retropubic radical prostatectomy with sentinel-guided pelvic LN dissection were included. LNs were investigated by routine histopathology. Tumor cell load was quantified by %immunocytochemistry. immunocytochemical single cell analysis. Gene activity was determined by qRT-PCR.
  
  
  RESULTS
  Twenty four out of 226 LNs were positive in routine histopathology and 51 in single cell analysis. PSA mRNA level correlated with tumor cell density in patients with a positive immunocytochemistry. Gene activity of PCA3 was upregulated in metastatic LNs and correlated with tumor cell density in patients with tumor-invaded LNs as detected by immunocytochemistry.
  
  
  CONCLUSIONS
  PCA3 gene expression discriminates LN metastasis and might outperform PSA gene activity in reflecting tumor cell burden in pelvic LNs of PCa patients.
authors.affiliation: Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Igor
authors.initials: I
authors.lastname: Tsaur
authors.affiliation: Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Hennenlotter
authors.affiliation: Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Elsie
authors.initials: E
authors.lastname: Oppermann
authors.affiliation: Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Marita
authors.initials: M
authors.lastname: Munz
authors.affiliation: Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Ursula
authors.initials: U
authors.lastname: Kuehs
authors.affiliation: Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.affiliation: Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.|Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Schilling
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000556:secondary; D000951:Antigens, Neoplasm / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000235:genetics*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000473:pathology; D012333:RNA, Messenger / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D047368:Tumor Burden
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D012333:RNA, Messenger; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen
keywords: PCA3; PSA; Prostate cancer; lymph node metastases; molecular marker; tumor cell load