Tj. Polascik et al., Influence of sextant prostate needle biopsy or surgery on the detection and harvest of intact circulating prostate cancer cells, J UROL, 162(3), 1999, pp. 749-752
Purpose: The feasibility of harvesting intact, circulating prostate cancer
cells from the blood of men with advanced prostate cancer has previously be
en demonstrated. We studied the influence of sextant prostate needle biopsy
and radical prostatectomy on harvesting intact circulating prostate cancer
cells.
Materials and Methods: Via standard venipuncture 20 cc blood were obtained
preoperatively, and 30 minutes and 3 days postoperatively from 23 men with
clinically localized prostate cancer undergoing surgery. Similarly, blood w
as obtained before and after routine prostate biopsy from 13 men for an ele
vated prostate specific antigen level and/or abnormal digital rectal examin
ation. The blood cells were removed via density centrifugation and magnetic
cell sorting. The remaining prostate epithelial cells were characterized b
y indirect fluorescent immunocytochemical staining and fluorescent in situ
hybridization using deoxyribonucleic acid probes.
Results: Sextant biopsy of the prostate induced circulating cells in 3 of 1
3 men (23%), only 1 of whom demonstrated cells with aneuploidy (Gleason sco
re 3 + 4 = 7). Circulating cells were detected preoperatively, 30 minutes o
r 3 days postoperatively in 35% of radical prostatectomy cases. Of the pati
ents 13% had detectable circulating cells 30 minutes postoperatively only a
nd 9% had cells harvested on postoperative day 3. Persistence of circulatin
g prostate cancer cells was noted in 13% of men on postoperative day 3. Ser
um prostate specific antigen level and pathological stage did not appear to
be related to harvested cell number.
Conclusions: Prostate cancer cells can be harvested from men with clinicall
y localized disease undergoing sextant needle biopsy or radical prostatecto
my. Routine prostate biopsy and surgery may influence the number of measura
ble circulating cells in the short term but the clinical significance and l
ong-term prevalence of detectable circulating cells are unknown. Further st
udies are needed to evaluate the clinical usefulness of this assay for dete
cting, staging and monitoring prostate cancer.