Transrectal ultrasound-guided prostate biopsy (TRUS) is a standard procedure for prostate cancer diagnosis. Because prostate cancer is a multifocal disease in many patients, multiple sampling (n ≥ 10) is required, which may bear the risk of systemic spread of cancer cells.
Using the standardized CellSearch® system that allows for the detection of single epithelial cell adhesion molecule-positive circulating tumor cells (CTCs) in blood, we investigated whether prostate biopsy is associated with release of prostatic tumor cells into the circulation. Peripheral blood was obtained before and within 30 min after performing prostate biopsy from 115 men with increased serum prostate-specific antigen.
The number of CTCs significantly increased after biopsy in men with histologically confirmed prostate cancer (odds ratio, 7.8; 95% CI, 4.8-12.8), whereas no biopsy-related changes could be detected in men without confirmed prostate cancer. Multivariable analysis showed that biopsy-related increase of CTCs was significantly correlated with a worse progression-free survival (hazard ratio, 12.4; 95% CI, 3.2-48.6) within the median follow-up of 41 months.
Prostate biopsies may lead to a tumor-associated release of CTCs into the blood circulation. Larger confirmatory trials with longer follow-up periods are required before any change in clinical practice can be recommended.
Clinical chemistry. 2019 Oct 10 [Epub ahead of print]
Simon A Joosse, Burkhard Beyer, Christin Gasch, Paulina Nastały, Andra Kuske, Hendrik Isbarn, Ludwig J Horst, Claudia Hille, Tobias M Gorges, Laure Cayrefourcq, Catherine Alix-Panabières, Pierre Tennstedt, Sabine Riethdorf, Thorsten Schlomm, Klaus Pantel
Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Laboratory of Rare Human Circulating Cells (LCCRH), University Medical Center and University of Montpellier, IURC, Montpellier, France., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; .