REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION ASSAYS FOR PROSTATE CANCER - 11/09/11
Résumé |
The molecular technologies of polymerase chain reaction (PCR) and reverse transcriptase–PCR (RT-PCR) are powerful tools for investigative medicine. These methods are being adapted increasingly for practical use in the clinical monitoring of patients with malignancy. As early as 1988, PCR alone was used in the detection of residual disease in patients treated for hematologic malignancies.21, 34, 37, 65 In these situations, the tumor cells are identifiable because they have an abnormally rearranged or mutated gene that is not present in normal cells. Therefore direct PCR amplification of genomic DNA from the genetic region involved in tumorigenesis can identify the presence of the abnormal DNA even if the tumor cells are greatly diluted in a population of normal cells. The additional step of reverse-transcribing cellular messenger RNA (mRNA) to complementary DNA (cDNA) in RT-PCR enables the detection of tissue-specific cell markers in cell populations without the need for a specific mutation or gene rearrangement in the tumor cell. The availability of cell-specific markers for prostate (and prostate cancer) cells has enabled the recent rapid development of RT-PCR techniques that can detect the dissemination of prostate cancer cells to metastatic sites in prostate cancer patients.13, 34, 42, 44, 60 As early as 1990, Vessella and coworkers66 reported on the detection of prostate cells by RT-PCR for prostate-specific antigen (PSA) in lymph nodes and bone marrow samples of patients with metastatic prostate cancer. In 1992, Moreno et al39 used RT-PCR to detect the presence of PSA mRNA in peripheral blood specimens of patients with metastatic prostate cancer. Since then, there have been numerous reports using this technology to detect the presence of occult prostate cells in blood, lymph nodes and bone marrow of patients with prostate cancer, and there is increasing evidence that this molecular assay provides clinically relevant information that can be used to improve treatment for patients with prostate cancer.
The aim of this article is to summarize the literature relating to these studies. In particular, the article focuses on specific areas including a review of RT-PCR technology; what problems are inherent in PCR-based technology, especially regarding its use in clinical assays; which prostate-specific marker might be used for these assays; how tissues compare for detection of prostate-specific markers; and what are the areas of consensus as well as those of continued controversy in the clinical application of this assay.
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| Address reprint requests to Carl A. Olsson, MD, Columbia University, College of Physicians and Surgeons, Atchley Pavilion, 11th Floor, 161 Fort Washington Avenue, New York, NY 10032 |
Vol 24 - N° 2
P. 367-378 - mai 1997 Retour au numéro
Article précédent
- MOLECULAR FORMS OF SERUM PROSTATE-SPECIFIC ANTIGEN : The Clinical Value of Percent Free Prostate-Specific Antigen
- Per-Anders Abrahamsson, Hans Lilja, Joseph E. Oesterling
- USE OF PROSTATE-SPECIFIC ANTIGEN, GLEASON SCORE, AND DIGITAL RECTAL EXAMINATION IN STAGING PATIENTS WITH NEWLY DIAGNOSED PROSTATE CANCER
- Michael A. Rees, Martin I. Resnick, Joseph E. Oesterling
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