前立腺癌における血行性微小播種の分子診断

Abstract

前立腺癌患者39例を対象に, 前立腺特異抗原(PSA)のmRNAを前立腺癌細胞のマーカーとした血行性癌微小播種の分子診断法を検討した. 1)対象患者39例中19例が陽性を示し, 前立腺肥大症患者5例, 急性前立腺患者1例, 女性患者1例はいずれも陰性であった. 2)患者のstage別の陽性率は, stage A1:0/1, A2:0/2, B:2/6, C:2/9, D0:3/3, D1:1/4, D2:11/14であった.病理学的分化度別の陽性率は, 高分化型:2/5, 中分化型:7/16, 低分化型:10/16であった

We have used a reverse transcriptase-polymerase chain reaction assay for prostate specific antigen (PSA) expression to detect hematogenous microdissemination in patients with prostate cancer. Thirty-nine consecutive patients with prostate cancer were surveyed. Nineteen patients (48.7%) were positive for PSA-expressing cells in this assay. Positivity rates by stage were as follows: stage A1-0/1, A2-0/2, B-2/6, C-2/9, D0-3/3, D1-1/4, D2-11/14. In clinically organ-confined cancers with a positive assay result, two stage C patients subsequently developed bone metastasis, while two stage B patients who were positive had no evidence of disease progression. In patients with a negative assay result, 3 of the 3 stage A, 3 of the 4 stage B, and 6 of the 7 stage C patients did not develop hematogenous dissemination during the follow-up period. Molecular assay for hematogenous microdissemination of prostate cancer cells provides an opportunity for earlier detection of disseminated disease and may have prognostic value.