Affiliations: [a] Department of Urology, University Hospital Frankfurt, Frankfurt, Germany | [b] Department of Urology, University Hospital Tuebingen, Tuebingen, Germany | [c] Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany
Correspondence:
[*]
Corresponding author: David Schilling, Department of Urology, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. E-mail: david.schilling@kgu.de
Abstract:
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. 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.
immunocytochemical single cell analysis.
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.
