Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Urol Oncol. 2013 Jul;31(5):615-21. doi: 10.1016/j.urolonc.2011.04.003. Epub 2011 May 19.
To compare the accuracy to diagnose micrometastases to pelvic lymph nodes (LNs) in patients undergoing radical prostatectomy (RP) by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) targeting several genes specifically expressed in the prostate.
Expression of prostate-specific antigen (PSA), prostate-specific membrane antigen (PSMA), human kallikrein 2 (hK2), prostate stem cell antigen (PSCA), and differential display code 3 (DD3) in 2215 LNs isolated from 120 patients with localized prostate cancer were assessed by fully quantitative real-time RT-PCR.
In addition to pathologically diagnosed LN metastases in 11 patients, real-time RT-PCR targeting PSA, PSMA, hK2, PSCA, and DD3 further identified micrometastases in 23, 29, 31, 15, and 11, respectively. In this series, biochemical recurrence (BR) occurred in 32 patients, of whom 25, 22, 28, 10, and 9 were diagnosed as having micrometastases by real-time RT-PCR targeting PSA, PSMA, hK2, PSCA, and DD3, respectively. Univariate analysis identified pathologic stage, pathologic LN metastases, Gleason score, surgical margin status, and micrometastases detected by real-time RT-PCR targeting PSA, PSMA, hK2, and their combinations as significant predictors for BR-free survival (BRFS), of which only surgical margin status and micrometastases detected by real-time RT-PCR targeting PSA and hK2 appeared to be independently associated with BRFS on multivariate analysis.
Of PSA, PSMA, hK2, PSCA, DD3, and their combinations, combined analysis of PSA and/or hK2 expression in pelvic LNs by real-time RT-PCR could provide findings most precisely predicting BRFS following RP.
通过实时逆转录-聚合酶链反应（RT-PCR）针对前列腺中特异性表达的几个基因，比较检测接受根治性前列腺切除术（RP）的患者盆腔淋巴结（LNs）中微转移的准确性。
对 120 例局限性前列腺癌患者的 2215 个 LN 进行完全定量实时 RT-PCR 检测前列腺特异性抗原（PSA）、前列腺特异性膜抗原（PSMA）、人激肽释放酶 2（hK2）、前列腺干细胞抗原（PSCA）和差异显示代码 3（DD3）的表达。
除 11 例患者的病理性 LN 转移外，实时 RT-PCR 针对 PSA、PSMA、hK2、PSCA 和 DD3 的检测分别进一步确定了 23、29、31、15 和 11 例微转移。在该系列中，32 例患者发生生化复发（BR），其中 25、22、28、10 和 9 例分别通过实时 RT-PCR 针对 PSA、PSMA、hK2、PSCA 和 DD3 检测到微转移。单因素分析确定了病理分期、病理 LN 转移、Gleason 评分、手术切缘状态和实时 RT-PCR 针对 PSA、PSMA、hK2 及其组合检测到的微转移是 BR 无复发生存（BRFS）的显著预测因子，其中只有手术切缘状态和实时 RT-PCR 针对 PSA 和 hK2 检测到的微转移在多因素分析中显示与 BRFS 独立相关。
在 PSA、PSMA、hK2、PSCA、DD3 及其组合中，实时 RT-PCR 针对 PSA 和/或 hK2 在盆腔 LNs 中的联合分析可以提供最准确的预测 RP 后 BRFS 的发现。
