Detection of Circulating Prostate Cancer Cells by Measurement of PSA mRNA

Amplification of organ-specific mRNA by reverse transcription-polymerase chain reaction (RT-PCR) is a powerful method for detection of circulating prostate cancer cells. Many groups have reported detection of PSA mRNA in circulating cells by measurement of PSA mRNA by RT-PCR [173] and this approach is potentially useful for evaluating the prognosis of prostate cancer. It has been suggested to improve preoperative staging and prognosis of prostate cancer [174, 175] by identifying preoperatively organ-confined and extracapsular cancers, respectively [176-178]. However, at present it is not clear whether PSA mRNA levels correlate with tumor stage and grade [179]. By RT-PCR even one circulating PSA expressing cell among more than 100 million other cells may be detected [180,181]. However, the method is prone to methodological problems and false-positive results have been found to be caused by low background expression of prostate-specific genes in normal hematopoietic tissues and blood cells [182, 183]. Therefore, the clinical utility of this method remains to be determined.

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