Ghossein R A, Rosai J, Scher H I, Seiden M, Zhang Z F, Sun M, Chang G, Berlane K, Krithivas K, Kantoff P W
Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Urology. 1997 Jul;50(1):100-5. doi: 10.1016/S0090-4295(97)00127-1.
To evaluate the prognostic significance of reverse transcriptase polymerase chain reaction (RT PCR) detection of prostate-specific antigen (PSA) mRNA in relation to survival in patients with metastatic androgen-independent prostatic carcinoma (AIPC).
Peripheral blood from 122 men (64 from Memorial Sloan-Kettering Cancer Center [MSKCC] and 58 from the Dana Farber Cancer Institute [DFCI]) with metastatic (Stage D2) AIPC was analyzed for PSA mRNA using RT PCR. Forty-one controls without prostatic carcinoma were also evaluated.
RT PCR positivity for PSA mRNA was present in 24 of the 64 (38%) patients seen at MSKCC and in 26 of the 58 (45%) patients followed at DFCI. All control individuals were PSA PCR negative. There was a significant correlation between RT PCR positivity and decreased survival in each of the Memorial and Dana Farber population (P = 0.028 and 0.039, respectively). Serum PSA (at time of blood collection for PCR) was not predictive of survival as a continuous variable in the MSKCC [P = 0.31] and the DFCI (P = 0.09) groups. RT PCR for PSA mRNA was found to be independent from and superior to serum PSA in predicting survival in both the MSKCC and DFCI populations (P = 0.048 and P = 0.027, respectively).
The detection of PSA mRNA in the peripheral blood by RT PCR is a predictor of survival in patients with metastatic AIPC, and PCR is superior to a single serum PSA measurement. Further studies are needed to test the value of this factor in comparison to and coupled with other prognostic parameters.
评估逆转录聚合酶链反应（RT-PCR）检测前列腺特异性抗原（PSA）mRNA对转移性雄激素非依赖性前列腺癌（AIPC）患者生存的预后意义。
采用RT-PCR分析122例转移性（D2期）AIPC男性患者（64例来自纪念斯隆凯特琳癌症中心[MSKCC]，58例来自达纳法伯癌症研究所[DFCI]）的外周血中的PSA mRNA。还评估了41例无前列腺癌的对照者。
在MSKCC就诊的64例患者中有24例（38%）PSA mRNA的RT-PCR呈阳性，在DFCI随访的58例患者中有26例（45%）呈阳性。所有对照个体的PSA PCR均为阴性。在纪念医院和达纳法伯医院的人群中，RT-PCR阳性与生存率降低之间均存在显著相关性（分别为P = 0.028和0.039）。在MSKCC组[P = 0.31]和DFCI组（P = 0.09）中，血清PSA（在采集血液进行PCR时）作为连续变量不能预测生存情况。发现在预测MSKCC和DFCI人群的生存方面，PSA mRNA的RT-PCR独立于血清PSA且优于血清PSA（分别为P = 0.048和P = 0.027）。
通过RT-PCR检测外周血中的PSA mRNA是转移性AIPC患者生存的一个预测指标，且PCR优于单次血清PSA测量。需要进一步研究来测试该因素与其他预后参数相比以及与之结合的价值。
