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

• Published in: Clinical cancer research 2004-09, Vol.10 (17), p.5808-5814
• Main Authors: KUREK, Ralf, NUNEZ, German, RENNEBERG, Heiner, TSELIS, Nikolaos, KONRAD, Lutz, MARTIN, Thomas, ROEDDIGER, Sandra, AUMÜLLER, Gerd, ZAMBOGLOU, Nikolaos, LIN, Daniel W, TUNN, Ulf W
• Format: Article
• Language: English
• Subjects: Antigens, Surface - blood; Antigens, Surface - genetics; Antineoplastic agents; Biological and medical sciences; Case-Control Studies; DNA, Complementary - genetics; Glutamate Carboxypeptidase II - blood; Glutamate Carboxypeptidase II - genetics; Humans; Lymph Nodes - metabolism; Male; Medical sciences; Neoplasm Staging; Pharmacology. Drug treatments; Prognosis; Prostate - metabolism; Prostate-Specific Antigen - blood; Prostate-Specific Antigen - genetics; Prostatic Neoplasms - blood; Prostatic Neoplasms - genetics; Prostatic Neoplasms - pathology; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger - blood; RNA, Neoplasm - blood; RNA, Neoplasm - genetics; Sensitivity and Specificity; Tissue Kallikreins - blood; Tissue Kallikreins - genetics; Tumor Cells, Cultured; Tumors
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-1004-03

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.