| Abstract: |
Previously, we reported that about 50% of prostate cancer patients had circulating tumor cells prior to radical prostatectomy regardless of whether they were subsequently found to have stage pT(2) or pT(3) disease, We also observed that after neoadjuvant hormone deprivation prior to prostatectomy, only 27% of patients expressed prostate specific membrane antigen (PSMA) by reverse transcriptase-polymerase chain reaction (RT-PCR), indicating that neoadjuvant hormone deprivation decreased the number of patients positive for circulating cells, With a median follow-up of 2 years, we have examined whether the presence of circulating cells detected by RT-PCR for PSMA was predictive of subsequent failure, as judged by prostate specific antigen (PSA), after radical prostatectomy and found that it was not. We had identified PSMA as a unique folate hydrolase and thus can potentially subject cells to folate deficiency. We questioned whether the presence of a thermolabile methylenetetrahydrofolate reductase (MTHFR) may identify a group of patients whose cancers would have a more aggressive phenotype, We did not find that patients with the thermolabile MTHFR phenotype were more likely to have disease recurrence after radical prostatectomy, Thus, better markers of malignant potential are required to identify those patients with prostate cancer who are destined to have a recurrence after prostatectomy. |
