Abstract
Background
As up to 50% of all patients with prostate cancer who have undergone radical prostatectomy are found to be understaged subsequent to surgery, a more sensitive early staging modality currently is needed. A molecular assay that detects prostate specific antigen (PSA)-synthesizing cells in the peripheral circulation of patients with prostate cancer is described.Methods
An enhanced reverse-transcriptase polymerase chain reaction (RT-PCR) assay specific for PSA mRNA was performed on RNA extracted from blood drawn from 94 patients before radical prostatectomy. Surgical specimens were examined to determine the extent of tumor spread. The assay was compared with imaging modalities, digital rectal examination, and serum PSA level as predictors of pathology. Additionally, patients were monitored postoperatively by serum PSA level to determine any potential correlation between patient RT-PCR scores and subsequent tumor recurrence.Results
Postoperative pathology revealed that 36 of the 94 patients had extraprostatic disease at the time of surgery. Enhanced RT-PCR identified 26 of these patients from preoperative blood specimens (72% sensitivity). The test was negative for 51 of the 58 patients with organ-confined disease (88% specificity). An odds ratio analysis showed that no other preoperative staging modality was related more strongly to extraprostatic or organ-confined disease. Follow-up PSA determinations revealed that RT-PCR positive patients were at higher risk for a recurrence. At 6 months after surgery, the rates for an increased PSA were 19 and 2% for RT-PCR-positive and -negative patients, respectively.Conclusions
The data from this follow-up study continue to support the utility of enhanced RT-PCR as an early staging modality for radical prostatectomy candidates.Full text links
Read article at publisher's site: https://doi.org/10.1002/1097-0142(19950401)75:7<1642::aid-cncr2820750714>3.0.co;2-1
References
Articles referenced by this article (24)
American Cancer Society--National Prostate Cancer Detection Project. Results from multiple examinations using transrectal ultrasound, digital rectal examination, and prostate specific antigen.
Cancer, (3 Suppl):891-898 1993
MED: 7679042
Predictive value of prostate-specific antigen density for the presence of micrometastatic carcinoma of the prostate.
Urology, (5):645-648 1994
MED: 7513107
, , , , , et al. Organ systems program staging classification for prostate cancer. In: , , , editors. A multidisciplinary analysis of controversies in the management of prostate cancer. New York: Plenum Press, 1988: 295–302.
An assessment of radical prostatectomy. Time trends, geographic variation, and outcomes. The Prostate Patient Outcomes Research Team.
JAMA, (20):2633-2636 1993
MED: 8487445
Postoperative radiotherapy for patients with carcinoma of the prostate undergoing radical prostatectomy with positive surgical margins, seminal vesicle involvement and/or penetration through the capsule.
J Urol, (6):1407-1412 1987
MED: 3682068
Morphologic analysis of surgical margins with positive findings in prostatectomy for adenocarcinoma of the prostate.
Cancer, (2):520-526 1992
MED: 1728383
Nerve-sparing radical prostatectomy: extraprostatic tumor extension and preservation of erectile function.
J Urol, (6):1149-1151 1985
MED: 4057407
Radical prostatectomy for the treatment of localized prostatic carcinoma.
Urol Clin North Am, (3):583-591 1980
MED: 7456171
The palpable nodule of prostatic cancer. Results 15 years after radical excision.
JAMA, (6):403-406 1968
MED: 5694122
Circulating prostate specific antigen-positive cells correlate with metastatic prostate cancer.
Br J Urol, (4):392-396 1992
MED: 1374678
Show 10 more references (10 of 24)
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Funding
Funders who supported this work.
NCI NIH HHS (2)
Grant ID: CA13696
Grant ID: CA58089