[Current role of PSA and other markers in the diagnosis of prostate cancer].
OBJECTIVE
To evaluate the current role of PSA as a diagnostic method for prostate cancer, as well as to analyze possible new markers.


METHODS
We perform a bibliographic review for PSA, and its molecular forms, as a marker to define the presence of prostate cancer. We review the factors related to PSA modifications, predictive models, or the current controversies about the usefulness of its cutpoint to define the risk of prostate cancer or the marker itself. We analyze possible new markers and the most interesting work lines in the development of new markers. We used MEDLINE for the bibliographic search.


RESULTS
Available data confirm that PSA has a high sensitivity; although specificity is low, mainly in the < 10 ng/ml range, it may be increased with the use of various molecular isoforms, ratios or predictive models. Nevertheless, it is true that despite such studies it is difficult to increase specificity, so biopsies are reduced. Currently we have new markers, some of them already marketed, others in development, which seem to improve the specificity of PSA (isoforms, use of molecular biology).


CONCLUSIONS
PSA is still the standard marker for the diagnosis of prostate cancer. It is important to improve the specificity; therefore we need new predictive models or new isoforms that help us to do a better selection of candidates for biopsy. There are various promising research lines with new markers, but there is not ideal substitute for PSA yet.
Gómez Veiga
F
F
Servicio de Urología, Complejo Hospitalario Universitario Juan Canalejo A Coruña, España. fgveiga@telefonica.net
Ponce Reixa
J
J
Barbagelata López
A
A
Fernández Rosado
E
E
Gonzaĺez Martiń
M
M
D015415:Biomarkers / Q000097:blood; D006801:Humans; D008297:Male; D008403:Mass Screening; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*
D015415:Biomarkers; D017430:Prostate-Specific Antigen