Emerging Biomarkers for the Diagnosis and Prognosis of Prostate Cancer

Early detection of prostate cancer (CaP), the most prevalent cancer and the second-leading cause of death in men, has proved difficult, and current detection methods are inadequate. Prostate-specific antigen (PSA) testing is a significant advance for early diagnosis of patients with CaP. PSA is prod...

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Bibliographic Details
Published in:Clinical chemistry (Baltimore, Md.) Md.), 2008-12, Vol.54 (12), p.1951-1960
Main Authors: Sardana, Girish, Dowell, Barry, Diamandis, Eleftherios P
Format: Article
Language:English
Subjects:
Analytical, structural and metabolic biochemistry
Antigens, Neoplasm - blood
Biological and medical sciences
Biomarkers
Biomarkers, Tumor - blood
Clinical outcomes
Fundamental and applied biological sciences. Psychology
GPI-Linked Proteins
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Mass spectrometry
Medical sciences
Membrane Glycoproteins - blood
Men
Mortality
Neoplasm Proteins - blood
Ovarian cancer
Prognosis
Prostate cancer
Prostate-Specific Antigen - blood
Prostatic Neoplasms - diagnosis
Protease inhibitors
Racemases and Epimerases - blood
Risk
Serine Endopeptidases - blood
Tissue Kallikreins - blood
Tissues
Tumors
Validation studies
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Summary:Early detection of prostate cancer (CaP), the most prevalent cancer and the second-leading cause of death in men, has proved difficult, and current detection methods are inadequate. Prostate-specific antigen (PSA) testing is a significant advance for early diagnosis of patients with CaP. PSA is produced almost exclusively in the prostate, and abnormalities of this organ are frequently associated with increased serum concentrations. Because of PSA's lack of specificity for CaP, however, many patients undergo unnecessary biopsies or treatments for benign or latent tumors, respectively. Thus, a more specific method of CaP detection is required to augment or replace screening with PSA. The focus recently has been on creating cost-effective assays for circulating protein biomarkers in the blood, but because of the heterogeneity of CaP, it has become clear that this effort will be a formidable challenge. Each marker will require proper validation to ensure clinical utility. Although much work has been done on variations of the PSA test (i.e., velocity, density, free vs bound, proisoforms) with limited usefulness, there are many emerging markers at various stages of development that show some promise for CaP diagnosis. These markers include kallikrein-related peptidase 2 (KLK2), early prostate cancer antigen (EPCA), PCA3, hepsin, prostate stem cell antigen, and alpha-methylacyl-CoA racemase (AMACR). We review biomarkers under investigation for the early diagnosis and management of prostate cancer. It is hoped that the use of panels of markers can improve CaP diagnosis and prognosis and help predict the therapeutic response in CaP patients.
ISSN:0009-9147
1530-8561
DOI:10.1373/clinchem.2008.110668