Molecular Staging of Prostatic Cancer with RT-PCR Assay for Prostate-Specific Antigen in Peripheral Blood and Lymph Nodes: Comparison with Standard Histological Staging and Immunohistochemical Assessment of Occult Regional Lymph Node Metastases

Background: About 30–40% of men with localized prostate cancer undergoing radical prostatectomy will have cancer recurrence. It is estimated that one third recur locally and two thirds develop distant metastases with or without local recurrence. Methods: In the present study we investigate the detection of prostate-specific antigen (PSA) mRNA in peripheral blood samples ( n=200 patients) and pelvic lymph nodes ( n=154 patients) by PSA reverse transcriptase polymerase chain reaction (RT-PCR) and compare these results to standard histological and immunohistochemical staging. Results: We have observed a statistically significant correlation of lymph node PSA RT-PCR with standard pathologic risk factors, such as Gleason score ( p=0.011), the presence of Gleason patterns 4 or 5 ( p=0.005), lymph node metastasis ( p