Detection of circulating tumor cells in prostate cancer patients: methodological pitfalls and clinical relevance

Abstract

Disseminated malignancy is the major cause of prostate cancer-related mortality. Circulating tumor cells (CTCs) are essential for the establishment of metastasis. Various contemporary and molecular methods using prostate-specific biomarkers have been applied to detect extraprostatic disease that is undetectable by conventional imaging techniques, assessing the risk for disease recurrence after therapy of curative intent. However, the clinical relevance of CTC detection is still controversial. We review current literature regarding molecular methods used for the detection of CTCs in the peripheral blood and bone marrow biopsies of patients with prostate cancer, and we discuss the methodological pitfalls that influence the clinical significance of molecular staging.

Figure 1

An example of a multiplex PCR protocol for the detection of prostate-specific antigen (PSA), prostate-specific membrane antigen (PSMA), prostate stem-cell antigen (PSCA), parathyroid hormone–related protein (PTHrP), and cytokeratin 19 (CK19) mRNA in a peripheral blood sample from a prostate cancer patient. Lane M, size markers; lane A, sample from prostate cancer patient with metastatic disease; lane B, sample from healthy young male (negative control).