Ravery V
Clinique Urologique, Hôpital Bichat, Paris, France.
Prog Urol. 1997 Dec;7(6):925-9.
Despite the improvement current evaluation techniques, approximately 30% of prostatic cancers clinically localized to the gland are understaged. RT-PCR is a sensitive and specific screening method for circulating prostatic cells, proposed as a molecular staging tool. The results obtained with this method and reported in the literature are critically discussed. These results, concerning the detection of circulating PSA- or PSMA-positive prostatic cells, are only indicative, as none of the teams used the same method. No consensus has been reached concerning the equipment used, the choice of oligonucleotide primers, the number of cycles to be applied or even the type of method, classical or "nested". Another possible application of this method is early detection of circulating prostatic cells, possibly neoplastic, during the follow-up of patients treated by radical prostatectomy. Once again, the results of the literature are contradictory. The reliability and reproducibility of molecular biology techniques in routine practice must therefore be demonstrated before these techniques can influence the therapeutic decision concerning prostatic cancer.
尽管当前评估技术有所改进，但临床上局限于前列腺腺体的癌症中仍有大约30%分期过低。逆转录聚合酶链反应（RT-PCR）是一种针对循环前列腺细胞的灵敏且特异的筛查方法，被提议作为一种分子分期工具。本文对用该方法获得并在文献中报道的结果进行了批判性讨论。这些关于检测循环中前列腺特异性抗原（PSA）或前列腺特异性膜抗原（PSMA）阳性前列腺细胞的结果仅具有指示性，因为没有一个团队使用相同的方法。在使用的设备、寡核苷酸引物的选择、应用的循环次数甚至方法类型（经典法或“巢式”法）方面尚未达成共识。该方法的另一个可能应用是在接受根治性前列腺切除术的患者随访期间早期检测循环中的前列腺细胞，这些细胞可能是肿瘤性的。同样，文献结果相互矛盾。因此，在这些技术能够影响前列腺癌的治疗决策之前，必须证明分子生物学技术在常规实践中的可靠性和可重复性。
