Influence of sextant prostate needle biopsy or surgery on the detection and harvest of intact circulating prostate cancer cells

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.