The detection of prostate cells by the reverse transcription polymerase chain reaction in the circulation of patients undergoing transurethral resection of the prostate

Objective To determine whether prostate cells are disseminated into the cir culation of patients after transurethral resection of the prostate (TURP), as assessed by a reverse transcription-polymerase chain reaction (RT-PCR) a ssay for prostate specific antigen (PSA) mRNA. Patients and methods Fifty-one patients, comprising 34 with benign prostati c hyperplasia (BPH) and 17 with prostate cancer who were undergoing routine TURF, had blood samples taken before and 30 min after surgery. The blood m ononuclear cell layer was isolated by density-gradient centrifugation and t otal RNA extracted. Complementary DNA was synthesized by RT of the RNA. The target PSA sequence was amplified by PCR with specific PSA primers and the product detected on agarose-gel electrophoresis with ethidium bromide stai ning. Results Five patients (all with prostate cancer) were positive on PSA RT-PC R before surgery and remained positive after TURF. Of the remaining 46 pati ents, five (11%; three with BPH and two with cancer) changed from a negativ e to a positive result after TURF. Conclusion In a proportion of patients TURF causes the dissemination of pro state cells into the circulation which are then detectable by RT-PCR of PSA mRNA.