Pfitzenmaier Jesco, Ellis William J, Hawley Sarah, Arfman Edward W, Klein Jeffrey R, Lange Paul H, Vessella Robert L
Department of Urology, Medical School, University of Washington, Seattle, WA 98195-6510, USA.
Urol Oncol. 2007 May-Jun;25(3):214-20. doi: 10.1016/j.urolonc.2006.09.018.
To isolate prostate epithelial cells from the peripheral blood and bone marrow, and compare prostate-specific antigen (PSA) reverse transcriptase polymerase chain reaction (RT-PCR) performed on unenriched or epithelial enriched peripheral blood and bone marrow samples.
Peripheral blood samples from 371 patients with prostate cancer and 141 controls, and bone marrow samples from 292 patients with prostate cancer and 43 controls were obtained. One aliquot was assessed with PSA RT-PCR. Another was enriched for epithelial cells with paramagnetic immune microbeads and assessed for: (1) PSA immunohistochemistry, (2) PSA RT-PCR, and (3) immunofluorescent detection of epithelial cells.
In the bone marrow (P < 0.01), but not the peripheral blood (P = 0.62), we observed significantly higher detection rates of disseminated PSA expressing epithelial cells after enrichment. The presence of epithelial cells with or without evidence of PSA production was uncommon among controls both in peripheral blood (1% and 0%) and bone marrow (11% and 0%). In patients with active prostate cancer, 46% to 74% had epithelial cells in peripheral blood, and 20% to 64% had PSA expressing epithelial cells. In bone marrow, 55% to 92% had epithelial cells, and 43% to 83% had PSA expressing epithelial cells. Particularly in bone marrow, circulating cells were frequently detected in men without evidence of disease after prostatectomy. With limited follow-up, the detection of epithelial cells or PSA expressing epithelial cells in peripheral blood or bone marrow before radical prostatectomy does not define a population of patients that will have biochemical failure.
Immunomagnetic enrichment frequently detects epithelial, presumably malignant, cells in the peripheral blood and, especially, the bone marrow of patients with prostate cancer. Viable cells can be acquired for gene expression and phenotyping studies.
从外周血和骨髓中分离前列腺上皮细胞，并比较在未富集或上皮细胞富集的外周血和骨髓样本上进行的前列腺特异性抗原（PSA）逆转录聚合酶链反应（RT-PCR）。
获取了371例前列腺癌患者和141例对照的外周血样本，以及292例前列腺癌患者和43例对照的骨髓样本。一份样本进行PSA RT-PCR检测。另一份样本用顺磁性免疫微珠富集上皮细胞，并进行以下检测：（1）PSA免疫组织化学，（2）PSA RT-PCR，以及（3）上皮细胞的免疫荧光检测。
在骨髓中（P < 0.01），而非外周血中（P = 0.62），我们观察到富集后表达PSA的播散性上皮细胞的检出率显著更高。无论是否有PSA产生证据的上皮细胞在对照的外周血（1%和0%）和骨髓（11%和0%）中都不常见。在患有活动性前列腺癌的患者中，46%至74%的外周血中有上皮细胞，20%至64%的有表达PSA的上皮细胞。在骨髓中，55%至92%的有上皮细胞，43%至83%的有表达PSA的上皮细胞。特别是在骨髓中，前列腺切除术后无疾病证据的男性中经常检测到循环细胞。随访有限，在根治性前列腺切除术前行外周血或骨髓中上皮细胞或表达PSA的上皮细胞的检测并不能界定会发生生化失败的患者群体。
免疫磁珠富集法经常能在外周血尤其是前列腺癌患者的骨髓中检测到上皮细胞（推测为恶性细胞）。可获取活细胞用于基因表达和表型研究。
