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.

Abstract

PURPOSE:

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.

EXPERIMENTAL DESIGN:

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.

• Authors: Ralf Kurek, German Nunez, Nikolaos Tselis, Lutz Konrad, Thomas Martin, Sandra Roeddiger, Gerd Aumüller, Nikolaos Zamboglou, Daniel W Lin, Ulf W Tunn, Heiner Renneberg
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 10 Issue 17 Pg. 5808-14 (Sep 01 2004) ISSN: 1078-0432 [Print] United States
• PMID: 15355910 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, Surface
• DNA, Complementary
• RNA, Messenger
• RNA, Neoplasm
• FOLH1 protein, human
• Glutamate Carboxypeptidase II
• Tissue Kallikreins
• Prostate-Specific Antigen

Topics

• Antigens, Surface (blood, genetics)
• Case-Control Studies
• DNA, Complementary (genetics)
• Glutamate Carboxypeptidase II (blood, genetics)
• Humans
• Lymph Nodes (metabolism)
• Male
• Neoplasm Staging
• Prognosis
• Prostate (metabolism)
• Prostate-Specific Antigen (blood, genetics)
• Prostatic Neoplasms (blood, genetics, pathology)
• RNA, Messenger (blood)
• RNA, Neoplasm (blood, genetics)
• Reverse Transcriptase Polymerase Chain Reaction
• Sensitivity and Specificity
• Tissue Kallikreins (blood, genetics)
• Tumor Cells, Cultured