Prostate specific antigen has maintained a key role as serum marker for prostate cancer (PCa) diagnosis and management since almost 25 years ago.
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However, suboptimal sensitivity and specificity, resulting in missed diagnoses, unnecessary prostate biopsies, as well as, detection of clinically indolent disease emphasize the need for new biomarkers.
OBJECTIVE: The purpose of this review is to examine the current status of tissue-based PCa markers, with special emphasis on recently marketed assays, and to evaluate their potential advantages to improve diagnosis, discriminate between indolent and aggressive disease, as well as, their role selecting therapeutic strategies.
EVIDENC SYNTHESIS: PubMed-based available literature provided primarily the core for this review. The more recent, larger size series, meta-analysis and frequently referred originals were prioritized. Advances in genomics, molecular technologies along with new immunohistochemical procedures have enabled the discovery and study of a growing number of PCA markers. In the past two years, these efforts have produced assays to more accurately detect and characterize the disease. We present the development and validation of tissue-based genetic tests, and discuss the challenge of incorporating the use of these new markers into clinical practice.
CONCLUSIONS: Since prostate cancer is a heterogeneous disease, having a defined set of markers for early diagnosis, prognosis and follow-up, is clinically relevant. Some of these new markers can now be used to complement the conventional histopathologic diagnosis, as well as, to help already established parameters assessing prognosis.
Mora MJ. Are you the author?
Servicio de Urología, Hospital Universitario de la Princesa, Madrid, España.
Reference: Arch Esp Urol. 2015 Apr;68(3):250-66.
Article in Spanish.