290 ASSESSMENT OF THE MOST OPTIMAL TARGET GENE FOR DETECTING MICROMETASTASES IN PELVIC LYMPH NODES IN PATIENTS WITH PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY BY REAL-TIME REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION

Abstract

You have accessJournal of UrologyProstate Cancer: Staging1 Apr 2011290 ASSESSMENT OF THE MOST OPTIMAL TARGET GENE FOR DETECTING MICROMETASTASES IN PELVIC LYMPH NODES IN PATIENTS WITH PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY BY REAL-TIME REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION Yuji Kusuda, Hideaki Miyake, Sadao Kamidono, and Masato Fujisawa Yuji KusudaYuji Kusuda Kobe, Japan More articles by this author , Hideaki MiyakeHideaki Miyake Kobe, Japan More articles by this author , Sadao KamidonoSadao Kamidono Kobe, Japan More articles by this author , and Masato FujisawaMasato Fujisawa Kobe, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.383AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We previously reported the usefulness of real-time RT-PCR targeting PSA and PSMA genes for detecting mictometastatic tumor foci in pelvic lymph nodes (LNs) from patients with localized prostate cancer (Clin Cancer Res 2007; 13: 1192–7, BJU Int 2007; 99: 315–20). The objective of this study was to compare the accuracy to diagnose micrometastases to pelvic 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. METHODS 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. When sensitivity was calculated based on the combined outcomes obtained from two target genes, we regarded specimens in which either mRNA of target genes was positive as showing the ″presence of micrometastases″. RESULTS 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, PSCM and DD3, respectively. Univariate analysis identified pathological stage, pathological 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. CONCLUSIONS Of several potential target genes 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 BR following RP. Accordingly, it would be strongly recommended to perform real-time RT-PCR targeting both PSA and hK2 genes for detecting micrometastases in pelvic LNs in patients undergoing RP. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e118 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yuji Kusuda Kobe, Japan More articles by this author Hideaki Miyake Kobe, Japan More articles by this author Sadao Kamidono Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...