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Expression of Prostate-specific Membrane Antigen in Transitional Cell Carcinoma of the Bladder: Prognostic Value?¹

Applied Molecular Technology, Department of Clinical Biochemistry, Saint-Luc Clinical University, Université Catholique de Louvain, 1200 Brussels, Belgium [J-L. G., M. H., P. D. N.]; Queen Astrid Military Hospital, 1120 Brussels, Belgium [J-L. G.]; Clinical Biochemistry Laboratory, St. Antoine University Hospital, 75012 Paris, and Cellular Differentiation Laboratory, Pasteur Institute, CNRS URA 1960, 75015 Paris, France [S. L.]; Departments of Pathology [Y. G.] and Urology [P. V. C., B. T.], Saint-Luc Clinical University, Brussels 1200, Belgium; Johns Hopkins Oncology Center, Baltimore, Maryland 21287 [S. R. D., A. G.]; Ludwig Institute for Cancer Research, Brussels 1200, Belgium [F. B.]; and Department of Urology, Hôpital Bicêtre, Le Kremlin-Bicêtre 94270, France [P. E.]

The expression of Prostate-specific membrane antigen (PSMA) mRNA was assessed in the normal bladder urothelium (n = 9), transitional cell carcinoma (TCC) specimens (n = 52), TCC-derived cell lines (n = 3), and preoperative blood samples from TCC patients (n = 27). Specific PSMA mRNA was found in 100% of normal and malignant tissues and two cell lines. PSMA protein was detected in normal (n = 3) and malignant tissues (n = 4). Using a PSMA-specific substrate, PSMA enzymatic activity was found in two bladder cell lines and correlated with immunostaining. Seven of the 27 TCC preoperative blood samples were positive by reverse transcription-PCR. These preliminary results, obtained on a nonrandomized cohort of patients, correlated with tumor invasion (positive RT-PCR: 0% for pT 2 versus 41% for pT 3) and 2-year survival rate (81% in the PSMA-negative group versus 29% in the PSMA-positive group). Although the clinical usefulness of this assay requires confirmation in larger prospective randomized trials, current preliminary results suggest that a blood-borne PSMA mRNA PCR assay may be a useful tool to predict a poor outcome in TCC patients.

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