BACKGROUND: Extent of pelvic lymph node (LN) dissemination is a critical prognostic feature for patients with prostate cancer (PCa) maintaining extended pelvic lymphadenectomy (LAD) as the gold standard for LN-staging.
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Unfortunately, conventional histopathological assessment may miss micrometastasis and recently presented immunocytochemical approach of the single cell analysis is still intricate.
OBJECTIVE: To comparatively assess the potential of Prostate cancer gene 3 (PCA3) and prostate specific antigene (PSA) to perform as markers for tumor cell load.
METHODS: Patients with high risk PCa for LN metastasis undergoing either a sentinel LN-guided staging LAD or retropubic radical prostatectomy with sentinel-guided pelvic LN dissection were included. LNs were investigated by routine histopathology. Tumor cell load was quantified by immunocytochemistry. Gene activity was determined by qRT-PCR.
RESULTS: Twenty four out of 226 LNs were positive in routine histopathology and 51 in single cell analysis. PSA mRNA level correlated with tumor cell density in patients with a positive immunocytochemistry. Gene activity of PCA3 was upregulated in metastatic LNs and correlated with tumor cell density in patients with tumor-invaded LNs as detected by immunocytochemistry.
CONCLUSIONS: PCA3 gene expression discriminates LN metastasis and might outperform PSA gene activity in reflecting tumor cell burden in pelvic LNs of PCa patients.
Tsaur I, Hennenlotter J, Oppermann E, Munz M, Kuehs U, Stenzl A, Schilling D. Are you the author?
Department of Urology, University Hospital Frankfurt, Frankfurt, Germany; Department of Urology, University Hospital Tuebingen, Tuebingen, Germany; Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany; Department of Urology, University Hospital Tuebingen, Tuebingen, Germany.
Reference: Cancer Biomark. 2015 Mar 3. Epub ahead of print.