J Korean Med Sci.  2010 Sep;25(9):1291-1295. 10.3346/jkms.2010.25.9.1291.

Prostate Specific Membrane Antigen mRNA in Blood as a Potential Predictor of Biochemical Recurrence after Radical Prostatectomy

• Joung JY
• Cho KS
• Chung HS
• Cho IC
• Kim JE
• Seo HK
• Chung J
• Park WS
• Choi MK
• Lee KH

• KMID: 1785907
• DOI: http://doi.org/10.3346/jkms.2010.25.9.1291

Abstract

We investigated whether the detection of prostate specific membrane antigen (PSMA) in blood preoperatively has predictive value for biochemical recurrence (BCR) after radical prostatectomy in patients with prostate cancer. All 134 patients scheduled to receive radical prostatectomy for prostate cancer were prospectively enrolled. The authors used nested reverse transcriptase-polymerase chain reaction (RT-PCR) assay to detect PSMA mRNA-bearing cells in peripheral blood, and analyzed the ability of PSMA mRNA positivity to predict BCR after surgery. PSMA-mRNA was detected in 24 (17.9%) patients by RT-PCR. Over a median follow-up of 20 months (range, 3 to 46 months), BCR developed in 15 patients (11.2%) and median time to BCR was 7 months (range, 3 to 25 months). Kaplan-Meier analysis revealed a significant difference between those positive or negative for PSMA in terms of recurrence-free actuarial probability (log rank P=0.0039). Multivariate analysis showed that positivity for PSMA mRNA (HR: 3.697, 95% CI 1.285-10.634, P=0.015) and a biopsy Gleason score of > or =7 (HR: 4.500, 95% CI 1.419-14.274, P=0.011) were independent preoperative predictors of BCR. The presence of PSMA mRNA in peripheral blood can be used to predict BCR after radical prostatectomy.

Keyword

Prostate Specific Membrane Antigen; Biochemical Recurrence; Prostatic Neoplasms

MeSH Terms

Aged
Antigens, Surface/*blood/genetics
Glutamate Carboxypeptidase II/*blood/genetics
Humans
Male
Middle Aged
Neoplasm Recurrence, Local/blood/*diagnosis
Predictive Value of Tests
*Prostatectomy
Prostatic Neoplasms/blood/*diagnosis/surgery
RNA, Messenger/*blood
Reverse Transcriptase Polymerase Chain Reaction
Severity of Illness Index
Time Factors

Figure

• 

  Fig. 1 Kaplan-Meier plot of the likelihood of RT-PCR PSMA positive cases remaining free of biochemical recurrence after radical prostatectomy (log rank P=0.0039). PSMA, prostate specific membrane antigen; BCR, biochemical recurrence.

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