Detection of clinically significant, occult prostate cancer metastases in lymph nodes using a splice variant-specific RT-PCR assay for human glandular kallikrein Journal Article


Authors: Shariat, S. F.; Kattan, M. W.; Erdamar, S.; Nguyen, C.; Scardino, P. T.; Spencer, D. M.; Wheeler, T. M.; Slawin, K. M.
Article Title: Detection of clinically significant, occult prostate cancer metastases in lymph nodes using a splice variant-specific RT-PCR assay for human glandular kallikrein
Abstract: Purpose: To compare the detection of human glandular kallikrein 2 (hK2) mRNA expression in archival lymph nodes with disease progression, the development of prostate cancer metastases, and mortality in patients undergoing radical prostatectomy for locally advanced nonmetastatic prostate cancer. Patients and Methods: We evaluated total RNA extracted from fixed, paraffin-embedded, histopathologically normal pelvic lymph nodes, removed at radical prostatectomy, from 199 pT3N0 prostate cancer patients (150 extraprostatic extension only; 49 seminal vesicle involvement) for hK2-expressing cells using a novel reverse transcriptase polymerase chain reaction (RT-PCR)/hK2 assay. Cumulative incidence functions and Cox proportional hazards analyses were performed. Results: Forty patients (20%) had positive results, 80 patients (40%) had negative results, and 79 patients (40%) had equivocal results. RT-PCR/hK2 status was not associated with any pathologic characteristics (P > .05). In postoperative multivariable models, the RT-PCR/HK2 result was associated with prostate cancer progression (P = .001), development of distant metastases (P = .001), and prostate cancer-specific survival (P = .005). In patients experiencing biochemical progression (n = 33), RT-PCR/ hK2 status was a predictor of failure to respond to salvage radiotherapy (P = .002). Conclusion: RT-PCR/hK2 can detect biologically and clinically significant occult prostate cancer metastases in histopathologically normal lymph nodes. In patients with locally advanced prostate cancer, RT-PCR/HK2 is strongly associated with prostate cancer progression, failure following salvage radiation therapy, development of clinically evident metastases, and prostate cancer-specific mortality after surgery. © 2003 by American Society of Clinical Oncology.
Keywords: cancer survival; controlled study; human tissue; protein expression; aged; middle aged; major clinical study; genetics; disease course; histopathology; mortality; salvage therapy; cancer growth; comparative study; follow up; follow-up studies; lymph node metastasis; cancer incidence; lymph nodes; lymphatic metastasis; metastasis; reverse transcription polymerase chain reaction; pathology; cancer mortality; prostate cancer; prostatic neoplasms; biosynthesis; chemistry; proportional hazards model; diagnostic agent; messenger rna; reverse transcriptase polymerase chain reaction; rna, messenger; prostatectomy; disease progression; lymph node; prostate tumor; kallikrein; multivariate analysis; dna primers; primer dna; seminal vesicle; complementary dna; dna, complementary; tissue kallikrein; tissue kallikreins; seminal vesicles; humans; human; male; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 21
Issue: 7
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2003-04-01
Start Page: 1223
End Page: 1231
Language: English
DOI: 10.1200/jco.2003.08.142
PUBMED: 12663708
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Peter T Scardino
    622 Scardino
  2. Michael W Kattan
    218 Kattan