Tumor markers in prostate cancer

Abstract

Prostatic specific antigen (PSA) is a tissue specific marker that is now the most widely used biochemical test for the assessment and follow‐up of prostate cancer. The levels of PSA rise with tumor stage, but there is considerable overlap of their distribution between stages. PSA measurement now forms a part of the workup of a suspected carcinoma of the prostate, with a level of more than 4 ng/ml being an indication for further investigation. The sensitivity of PSA makes it an essential test for the postoperative assessment of radical prostatectomy and curative radiation therapy. The rates of change of PSA levels in locally advanced and metastatic disease treated by hormone manipulation can provide prognostic information. Low levels of PSA (< 10 ng/ml) 6 months after treatment are a sign that the response will be prolonged. However, the sensitivity of PSA often results in a rising level preceding clinical evidence of progression by several months and is not necessarily an indication to change treatment. Alkaline phosphatase and prostatic acid phosphatase provide a less sensitive test for the bone response to skeletal metastases and tumor activity in advanced disease, respectively.

Proliferating‐cell nuclear antigen (PCNA) as an independent prognostic marker in patients after prostatectomy: a comparison of PCNA and Ki‐67

“…The discrepancy between the results of these studies may hint that there may be prognostic factors other than grade in this group of patients. New markers of biological potential, such as those related to angiogenesis, cellular adhesion or proliferation, might be used for this purpose [11–17]. As grade is a very dominant prognostic variable, new markers could only be tested in a neutral environment for Gleason grade.…”

Cutaneous metastasis of prostatic adenocarcinoma: a cautionary tale

“…Elevated blood levels of PSA are used as a noninvasive method of screening for prostatic adenocarcinoma and monitoring disease progression. PSA represents the most commonly used immunohistochemical stain for prostatic adenocarcinoma 3 …”

“…PSA represents the most commonly used immunohistochemical stain for prostatic adenocarcinoma. 3 PAP is a protein with phosphatase activity that is expressed in normal genitourinary structures, including the prostate. PAP preceded PSA as a blood serum marker for prostate cancer and was replaced when the latter was found to be more reliable.…”

Tumor Markers in Clinical and Diagnostic Oncology - Revisited

“…It was used before the Prostate specific antigen (PSA) test was developed but is seldom used now because the PSA test is better. 25 Alkaline phosphatise, an iso-enzyme, is synthesized in the liver, bones or placenta. Elevated serum concentrations in patients with malignant disease usually indicate a metastatic spread of the disease into the liver and/or bones, and/or the presence of primary bone tumors such as osteosarcoma.…”