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Journal of Oncology
Volume 2014, Article ID 612674, 6 pages
Research Article

Primary Circulating Prostate Cells Are Not Detected in Men with Low Grade Small Volume Prostate Cancer

1Hospital Carabineros of Chile, Nunoa, 7770199 Santiago, Chile
2Circulating Tumor Cell Unit, Faculty of Medicine, University Mayor, Las Condes, 7550224 Santiago, Chile
3Institute of Bio-Oncology, Providencia, 7500710 Santiago, Chile
4Faculty of Medicine, Diego Portales University, Manuel Rodríguez Sur 415, 8370179 Santiago, Chile

Received 9 May 2014; Revised 12 July 2014; Accepted 28 July 2014; Published 19 August 2014

Academic Editor: M. Roach

Copyright © 2014 Nigel P. Murray et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To determine if primary circulating prostate cells (CPCs) are found in all men with prostate cancer. Methods and Patients. A prospective study, to analyze all men with an elevated PSA between 4.0 and 10.0 ng/mL undergoing initial biopsy. Primary CPCs were obtained by differential gel centrifugation and detected using standard immunocytochemistry using anti-PSA; positive samples underwent a second process with anti-P504S. A malignant primary CPC was defined as PSA (+) P504S (+) and a test positive if 1 cell/4 mL was detected. Biopsy results were registered as cancer/no-cancer, number of cores positive, and percent infiltration of the cores. Results. 328/1123 (29.2%) of the study population had prostate cancer diagnosed on initial biopsy, and 42/328 (12.8%) were negative for primary CPCs. CPC negative men were significantly older, and had lower PSA levels, lower Gleason scores, and fewer positive cores and with infiltration by the cancer. 38/42 (91%) of CPC negative men complied with the criteria for active surveillance in comparison with 34/286 (12%) of CPC positive men. Conclusions. Using primary CPC detection as a sequential test to select men with an elevated PSA for biopsy, the risk of missing clinically significant prostate cancer is minimal when the patient is primary CPC negative; less than 0.5% of all primary CPC negative men had a clinically significant prostate cancer.