This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grasso, Y. Z. Articles by Klein, E. A. Search for Related Content PubMed PubMed Citation Articles by Grasso, Y. Z. Articles by Klein, E. A.

Combined Nested RT-PCR Assay for Prostate-specific Antigen and Prostate-specific Membrane Antigen in Prostate Cancer Patients: Correlation with Pathological Stage¹

Departments of Clinical Pathology [Y. Z. G., M. K. G.], Anatomic Pathology [H. S. L.], and Urology [C. D. Z., E. A. K.], The Cleveland Clinic Foundation, Cleveland, Ohio 44195

Nested reverse transcription (RT)-PCR for prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSM) can detect circulating prostatic cells in patients with prostate cancer. We evaluated the role of a combined screening approach for PSA and PSM in prostate cancer staging. We examined the peripheral blood samples from 136 patients with adenocarcinoma of the prostate (PCA), 15 patients with benign prostatic hyperplasia, 15 normal male subjects, and 5 female subjects. The controls (benign prostatic hyperplasias, normal males, and normal females) were negative for both PSA and PSM. In patients with metastatic PCA (n = 11), 100% were positive by combined PSA/PSM (64% by PSA and 91% by PSM). In biochemical failure PCA patients (n = 18), 39% were positive by PSM, compared to only 6% by PSA. In patients with clinically localized PCA (n = 107), 48% were positive by combined PSA/PSM approach (43% by PSM and 14% by PSA). These results show that PSM is a more sensitive marker than PSA in detecting circulating prostatic cells (P < 0.0001). We correlated preoperative RT-PCR results with final pathological stages in 67 prostatectomy patients. RT-PCR positivity was 81.5% in patients with non-organ-confined disease versus 37.5% in organ-confined disease (P = 0.001). PSA/PSM RT-PCR had an odds ratio of 7.3 (95% confidence interval, 2.3–23.4; P = 0.001) in predicting tumor extracapsular extension. PSA/PSM RT-PCR was a better predictor of tumor extracapsular extension than initial serum PSA, clinical stage, and biopsy Gleason score. Our data show that PSA/PSM nested RT-PCR may provide the staging information unavailable from the current modalities. The ultimate impact of this technique in the management of patients with prostate cancer will require continued investigation.

¹ Supported by The Cleveland Clinic Foundation Research Program Committee Grant 5730.

² To whom requests for reprints should be addressed, at The Cleveland Clinic Foundation, Department of Clinical Pathology, L11, Cleveland, OH 44195. Phone: (216) 444-2714.

Received 11/ 5/97. Accepted 2/ 2/98.

This article has been cited by other articles:

				B. BICKERS and C. AUKIM-HASTIE New Molecular Biomarkers for the Prognosis and Management of Prostate Cancer - The Post PSA Era Anticancer Res, August 1, 2009; 29(8): 3289 - 3298. [Abstract] [Full Text] [PDF]

				K Fizazi, L Morat, L Chauveinc, D Prapotnich, R De Crevoisier, B Escudier, X Cathelineau, F Rozet, G Vallancien, L Sabatier, et al. High detection rate of circulating tumor cells in blood of patients with prostate cancer using telomerase activity Ann. Onc., March 1, 2007; 18(3): 518 - 521. [Abstract] [Full Text] [PDF]

				K. Patel, P. J. Whelan, S. Prescott, S. C. Brownhill, C. F. Johnston, P. J. Selby, and S. A. Burchill The Use of Real-Time Reverse Transcription-PCR for Prostate-Specific Antigen mRNA to Discriminate between Blood Samples from Healthy Volunteers and from Patients with Metastatic Prostate Cancer Clin. Cancer Res., November 15, 2004; 10(22): 7511 - 7519. [Abstract] [Full Text] [PDF]

				R. Kurek, G. Nunez, N. Tselis, L. Konrad, T. Martin, S. Roeddiger, G. Aumuller, N. Zamboglou, D. W. Lin, U. W. Tunn, et al. 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 Clin. Cancer Res., September 1, 2004; 10(17): 5808 - 5814. [Abstract] [Full Text] [PDF]

				P. Chinnappa, L. Taguba, R. Arciaga, C. Faiman, A. Siperstein, A. E. Mehta, S. K. Reddy, C. Nasr, and M. K. Gupta Detection of Thyrotropin-Receptor Messenger Ribonucleic Acid (mRNA) and Thyroglobulin mRNA Transcripts in Peripheral Blood of Patients with Thyroid Disease: Sensitive and Specific Markers for Thyroid Cancer J. Clin. Endocrinol. Metab., August 1, 2004; 89(8): 3705 - 3709. [Abstract] [Full Text] [PDF]

				S. F. Shariat, M. W. Kattan, W. Song, D. Bernard, E. Gottenger, T. M. Wheeler, and K. M. Slawin Early Postoperative Peripheral Blood Reverse Transcription PCR Assay for Prostate-specific Antigen Is Associated with Prostate Cancer Progression in Patients Undergoing Radical Prostatectomy Cancer Res., September 15, 2003; 63(18): 5874 - 5878. [Abstract] [Full Text] [PDF]

				S. F. Shariat, E. Gottenger, C. Nguyen, W. Song, M. W. Kattan, J. Andenoro, T. M. Wheeler, D. M. Spencer, and K. M. Slawin Preoperative Blood Reverse Transcriptase-PCR Assays for Prostate-specific Antigen and Human Glandular Kallikrein for Prediction of Prostate Cancer Progression after Radical Prostatectomy Cancer Res., October 15, 2002; 62(20): 5974 - 5979. [Abstract] [Full Text] [PDF]

				M. K. Gupta, L. Taguba, R. Arciaga, A. Siperstein, C. Faiman, A. Mehta, and S. S. K. Reddy Detection of Circulating Thyroid Cancer Cells by Reverse Transcription-PCR for Thyroid-stimulating Hormone Receptor and Thyroglobulin: The Importance of Primer Selection Clin. Chem., October 1, 2002; 48(10): 1862 - 1865. [Full Text] [PDF]

				J. Thomas, M. Gupta, Y. Grasso, C. A. Reddy, W. D. Heston, C. Zippe, R. Dreicer, P. A. Kupelian, J. Brainard, H. S. Levin, et al. Preoperative Combined Nested Reverse Transcriptase Polymerase Chain Reaction for Prostate-Specific Antigen and Prostate-Specific Membrane Antigen Does Not Correlate With Pathologic Stage or Biochemical Failure in Patients With Localized Prostate Cancer Undergoing Radical Prostatectomy J. Clin. Oncol., August 1, 2002; 20(15): 3213 - 3218. [Abstract] [Full Text] [PDF]

				T. A. Fava, R. Desnoyers, S. Schulz, J. Park, D. Weinberg, E. Mitchell, and S. A. Waldman Ectopic Expression of Guanylyl Cyclase C in CD34+ Progenitor Cells in Peripheral Blood J. Clin. Oncol., October 1, 2001; 19(19): 3951 - 3959. [Abstract] [Full Text]

				J.-J. Lu, Y. Kakehi, T. Takahashi, X.-X. Wu, T. Yuasa, T. Yoshiki, Y. Okada, T. Terachi, and O. Ogawa Detection of Circulating Cancer Cells by Reverse Transcription-Polymerase Chain Reaction for Uroplakin II in Peripheral Blood of Patients with Urothelial Cancer Clin. Cancer Res., August 1, 2000; 6(8): 3166 - 3171. [Abstract] [Full Text]