Detection of circulating tumour cells in prostatic cancer patients using polymerase chain reaction.
Author(s): Ola Sharaki, Seif Al Islam Nafis Abla abou zeid, Nermine Hossam*, Rasha Nour
Abstract
Cancer of the prostate is recognized as one of the principal medical problems facing the male population. Worldwide, prostate cancer is the second most common cancer in males after lung cancer. It accounts for 13% of all cancers in males worldwide. The incidence of prostate cancer in the Middle East, including Egypt, has been reported to be lower than the western world. However, in the last decade, increased diagnosis of prostate cancer is noted by urologists in their clinical practice. This might reflect increased awareness, improved diagnostic tools or increased incidence. Both genetic and environmental factors play a role in the evolution of prostate cancer. The development of metastasis is a complex, multi-staged process in which the hematogenous spreading of tumour cells is considered to be an intermediate and essential step for the spread of the disease beyond the prostate. Thus circulating tumour cells (CTCs), also known as the ‘leukemic phase of solid tumours’, constitute the hematogenous route of metastasis, and are of utmost clinical importance during the metastatic cascade for the establishment of distant metastasis. The aim of this study was to determine the presence of hematogenous neoplastic cells in patients with prostate cancer. Reverse transcription (RT) polymerase chain reaction (PCR) of prostate- specific antigen (PSA) mRNA was used to detect the presence of circulating tumour cells in clinic-pathologically proven prostatic cancer patients, 56% of them were proven to have locally malignant tumour and 44% were diagnosed with metastatic prostate cancer. 26.3 % of patients with locally malignant tumour were positive for CTCs and 80% of patients with metastatic disease were positive for CTCs. There was a statistically significant positive correlation between CTCs and t- PSA, Gleason score and imaging studies. We recommend screening for CTCs as a routine in all newly diagnosed non metastatic prostate cancer patients for the early detection of metastasis and improved preoperative staging modalities for patients with localized prostate cancer, a need for improved predictive markers to facilitate treatment selection and to monitor the effect of treatment.
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