Takahashi T, Hoshi S, Kaneda T, Mou K, Orikasa S, Ohkawa A, Funato T, Sasaki T, Kimura N
Department of Urology Tohoku University School of Medicine, Sendai.
Rinsho Byori. 1996 Dec;44(12):1183-8.
We have developed a highly sensitive method to detect pelvic lymph node(LN) metastasis using reverse transcriptase-polymerase chain reaction(RT-PCR) with the primers specific for prostate-specific antigen(PSA) gene in combination with the fine needle aspiration biopsy(FNAB). The specimens were obtained from pelvic LN from 15 prostate cancer patients and 15 bladder cancer patients. The aspirated samples (0.05 approximately 0.1 ml) were used for detecting the fragment of PSA mRNA by RT-PCR and Southern blot analysis, and the rest of samples were submitted to conventional cytology. Expression of PSA gene was detected in 9 cases of FNAB samples including all 5 cytologically positive and further more 2 cytologically class III cases, and 2 of 8 cytologically negative cases. RT-PCR of FNAB samples from all cases of bladder cancer were negative for the detection of PSA gene. The sensitivity of PSA gene by RT-PCR was very high and could detect 10 degrees cancer cell. In conclusion, our study suggested that RT-PCR for detection of PSA gene in FNAB samples might become a new diagnostic tool for detection of small foci of prostatic cancer metastasis in LN and combination use of RT-PCR and cytology could greatly contribute to accuracy in diagnosis.
我们开发了一种高灵敏度的方法，通过使用针对前列腺特异性抗原（PSA）基因的引物进行逆转录聚合酶链反应（RT-PCR），并结合细针穿刺活检（FNAB）来检测盆腔淋巴结（LN）转移。标本取自15例前列腺癌患者和15例膀胱癌患者的盆腔LN。抽取的样本（约0.05至0.1毫升）用于通过RT-PCR和Southern印迹分析检测PSA mRNA片段，其余样本进行常规细胞学检查。在9例FNAB样本中检测到PSA基因表达，包括所有5例细胞学阳性以及另外2例细胞学III级病例，还有8例细胞学阴性病例中的2例。所有膀胱癌病例的FNAB样本RT-PCR检测PSA基因均为阴性。RT-PCR检测PSA基因的灵敏度非常高，能够检测到10个癌细胞。总之，我们的研究表明，RT-PCR检测FNAB样本中的PSA基因可能成为检测LN中前列腺癌转移小病灶的一种新诊断工具，并且RT-PCR与细胞学的联合使用可极大地提高诊断准确性。
