Reverse transcription-polymerase chain reaction detection of prostate-specific antigen, prostate-specific membrane antigen, and prostate stem cell antigen in one milliliter of peripheral blood: value for the staging of prostate cancer

Clin Cancer Res. 2002 Jun;8(6):1794-9.


Purpose: There have been several studies on the presence of circulating tumor cells in the peripheral blood of patients with malignant tumors including prostate cancer (PCa) using reverse transcription-PCR (RT-PCR). One of the aims of these studies was to obtain high sensitivity that would enable early-stage diagnosis. However, they varied in their detection rates, and the methods were rather complicated. We have improved the RT-PCR assay combining three prostate-associated molecules, prostate specific antigen (PSA), prostate specific membrane antigen (PSMA), and prostate stem cell antigen (PSCA) to reveal patients with poor prognosis.

Experimental design: Peripheral blood samples were obtained from 129 patients including 58 cases of PCa and 71 cases of nonmalignant disorders. Total RNA was extracted from 1 ml of whole blood using a commercially available kit.

Results: The sensitivity of PSA-, PSMA-, and PSCA-nested RT-PCR was verified with positive signals of a single LNCaP cell in 1 ml of female blood sample. PSA-, PSMA-, and PSCA-mRNA were detected in 7 (12.1%), 12 (20.7%), and 8 (13.8%) PCa, and in 1, 2, and 0 samples in nonmalignant disorders, respectively. Among 58 PCa patients, each PCR indicated the prognostic value in the hierarchy of PSCA>PSA>PSMA RT-PCR, and extraprostatic cases with positive PSCA PCR indicated lower disease-progression-free survival than those with negative PSCA PCR.

Conclusions: The present findings suggest that PSCA PCR would be most promising for the molecular staging of PCa. The present RT-PCR is a highly cost-effective and rapid procedure, enabling the molecular staging of PCa with RT-PCR as a diagnostic routine.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Antigens, Neoplasm
  • Biomarkers, Tumor / analysis*
  • DNA Primers / chemistry
  • Disease Progression
  • Disease-Free Survival
  • GPI-Linked Proteins
  • Humans
  • Male
  • Membrane Glycoproteins / blood*
  • Neoplasm Proteins / blood*
  • Neoplasm Staging
  • Prospective Studies
  • Prostate-Specific Antigen / blood*
  • Prostatic Hyperplasia / blood
  • Prostatic Hyperplasia / pathology
  • Prostatic Intraepithelial Neoplasia / blood
  • Prostatic Intraepithelial Neoplasia / pathology
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / pathology*
  • RNA, Neoplasm / metabolism
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Time Factors


  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • DNA Primers
  • GPI-Linked Proteins
  • Membrane Glycoproteins
  • Neoplasm Proteins
  • PSCA protein, human
  • RNA, Neoplasm
  • Prostate-Specific Antigen