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[Cancer Research 62, 5974-5979, October 15, 2002]
© 2002 American Association for Cancer Research

Tumor Biology

Preoperative Blood Reverse Transcriptase-PCR Assays for Prostate-specific Antigen and Human Glandular Kallikrein for Prediction of Prostate Cancer Progression after Radical Prostatectomy1

Shahrokh F. Shariat, Emanuel Gottenger, Cuong Nguyen, Weitao Song, Michael W. Kattan, John Andenoro, Thomas M. Wheeler, David M. Spencer and Kevin M. Slawin2

Matsunaga-Conte Prostate Cancer Research Center, Scott Department of Urology [S. F. S., E. G., C. N., W. S., J. A., T. M. W., K. M. S.], Department of Pathology [T. M. W.], and the Department of Immunology [D. M. S.], Baylor College of Medicine and The Methodist Hospital, Houston, Texas 77030, and Department of Urology [M. W. K.] and Department of Biostatistics [M. W. K.], Memorial Sloan-Kettering Cancer Center, New York, New York 10021

The association of the results reverse transcription-PCR (RT-PCR) assays for prostate-specific antigen (PSA) with prostate cancer stage and progression remains controversial. We have previously shown that RT-PCR amplification of a native human glandular kallikrein fragment (hK2-L), but not a splice-variant hK2 transcript (hK2-U), performed preoperatively on peripheral blood before radical prostatectomy is an independent predictor of metastases to lymph nodes [K. M. Slawin, et al., Cancer Res., 60: 7142–7148, 2000]. We evaluated the ability of preoperative peripheral blood RT-PCR for PSA and hK2 to predict prostate cancer progression after surgery. The study group consisted of 224 consecutive patients who underwent radical prostatectomy for clinically localized disease (median follow-up: 52.9 months). Also evaluated were 14 healthy men and 8 patients with hormone-naïve, prostate cancer metastatic to bone. RT-PCR for PSA, hK2-L, and hK2-U were positive in 24, 25, and 26%, respectively, of prostatectomy patients; 88, 71, and 86%, respectively, of patients with metastases to bones; 7, 14, and 36%, respectively, of healthy men. Preoperative RT-PCR-hK2-L positivity was associated with higher final Gleason sum (P = 0.028), with an increased risk of metastases to lymph nodes (P = 0.019) and with overall and aggressive disease progression (P = 0.0231 and P = 0.028, respectively). Preoperative blood RT-PCR-PSA and RT-PCR-hK2-U were not associated with characteristics or outcomes of prostate cancer. Preoperative blood RT-PCR for PSA and hK2-U are neither therapy-guiding staging tools nor prognostic indicators in patients with clinically localized prostate cancer. In contrast, preoperative RT-PCR-hK2-L status is associated with established markers of aggressive prostate cancer.




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