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Value of reverse transcription polymerase chain reaction assay in pathological stage T3N0 prostate cancer
Author(s) -
Okegawa Takatsugu,
Noda Haruhisa,
Kato Moriaki,
Miyata Akiomi,
Nutahara Kikuo,
Higashihara Eiji
Publication year - 2000
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/1097-0045(20000801)44:3<210::aid-pros5>3.0.co;2-u
Subject(s) - lymph , prostate cancer , medicine , prostatectomy , prostate , prostate specific antigen , pathology , lymph node , biochemical recurrence , pathological , reverse transcription polymerase chain reaction , urology , cancer , biology , gene expression , gene , biochemistry
BACKGROUND We tested the ability of the nested reverse transcription polymerase chain reaction (RT‐PCR) assay to detect signs of biochemical recurrence of prostate cancer in the lymph nodes and peripheral blood of patients with pT3N0 prostate cancer. METHODS Using lymph nodes and pre‐ and postoperative peripheral blood dissected from 30 patients with pT3N0 prostate cancer treated by radical prostatectomy, we used RT‐PCR for prostate‐specific membrane antigen (PSM) and serum prostate‐specific antigen (PSA) to determine the presence of prostate cancer. Results of the nested RT‐PCR assay were compared with pathological stages and biochemical recurrence. RESULTS Two of 13 patients with capsular penetration (15%), 6 of 10 patients with invasion of seminal vesicles (60%), and 3 of 7 patients with a positive surgical margin (43%) were RT‐PCR‐positive for PSM and/or PSA in the lymph nodes. Results of preoperative RT‐PCRs of peripheral blood for PSM and for PSA significantly differed between positive and negative results of RT‐PCR in lymph nodes ( P < 0.001 and P < 0.001, respectively). Results of postoperative RT‐PCRs of peripheral blood for PSM and for PSA also significantly different between positive and negative results of RT‐PCR in lymph nodes ( P = 0.011 and P = 0.001, respectively). Nine of 11 patients with positive nested RT‐PCR for PSM and/or PSA in the lymph nodes (82%) experienced biochemical recurrence. Significant difference in Kaplan‐Meier recurrence‐free actuarial curves was noted between patients who nested positive and negative on RT‐PCR in the lymph nodes, pre‐ and postoperative peripheral blood, biopsy and prostatectomy Gleason score, and preoperative PSA values. In multivariate analysis, biopsy and prostatectomy Gleason score ( P = 0.026, P = 0.020, respectively), pre‐ and postoperative RT‐PCR for PSM in peripheral blood ( P = 0.030 and P = 0.040, respectively), and RT‐PCR for PSM in lymph nodes ( P = 0.035) were independent prognostic factors. CONCLUSIONS Nested RT‐PCR assay of the lymph nodes or peripheral blood significantly predicted biochemical recurrence after surgery. It may help identify patients at risk for re‐currence and progression of prostate cancer. Prostate 44:210–218, 2000. © 2000 Wiley‐Liss, Inc.