吸引細胞を用いた前立腺癌骨盤内リンパ節転移の遺伝子診断

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CTによる骨盤内リンパ節転移診断はリンパ節が2cm以上にならないと診断できない.骨盤内リンパ節転移診断に対してMRIはCTを凌ぐものではない.骨盤内リンパ節吸引細胞よりのPSA遺伝子の検出は前立腺癌の早期リンパ節転移の診断法となる可能性があるWe have developed a highly sensitive method to detect pelvic lymph node metastasis using the reverse transcriptase-polymerase chain reaction (RT-PCR) with primers specific for prostate-specific antigen (PSA) gene. Fine needle aspiration biopsy (FNAB) of pelvic lymph nodes was performed in 24 patients with prostate cancer. Each aspirated sample (0.05-0.1 ml) was divided into 2 parts; one for RNA extraction and RT-PCR to detect the fragment of PSA mRNA, and the other to smear on a slide glass for conventional cytology. The PSA gene was detected by RT-PCR in 11 FNAB samples which included not only all 6 cytologically positive and 2 cytologically class III cases but also 3 of 16 cytologically negative cases. The PSA gene was not detected by RT-PCR of FNAB samples in any of the 20 cases of bladder cancer. Thus RT-PCR for detection of the PSA gene in FNAB samples may be useful as a new diagnostic technique for detection of early lymph node metastasis in prostate cancer and an additional tool for cytological diagnosis of prostate cancer.