title: [proPSA: a precursor of prostate-specific antigen, may improve the early diagnosis of prostate cancer].
abstract: Since its introduction as a mass-screen parameter for early detection of prostate cancer, PSA was credited for a significant revolution in the management of prostate disease. But over 2 decades of global experience with this marker have emphasized that the recommended threshold value of 4.0 ng/ml may not be valid in distinguishing tumor growth from benign proliferation of the prostate in over 30% of the cases. Hence, more advanced tools of PSA evaluation have been introduced such as "PSA velocity", "PSA density" or age-related PSA". Recently, precursor molecules of PSA were identified, which are assumed to be zymogen structures devoid of proteolytic activity. These precursor species known as pro-PSAs possess an additional "tail" ranging in size from 2 to 7 extra amino acids at the N terminus of PSA, and represent a fraction of the non-complex or "free PSA", that has usually been identified as a marker for non-cancerous proliferation of the prostate. Interestingly, one of these proPSA structures in particular, [-2]proPSA, has demonstrated to be more specifically indicative of prostate tumor growth in numerous clinical studies. Lately, a chemiluminescence kit has been approved by the European Health Agency as a more specific marker for diagnosis of prostate malignancy, mostly in men with PSA levels ranging from 2-10 ng/ml.
authors.affiliation: lnstitute of Chemical Pathology, Sheba Medical Center, Tel Hashomer. benamis@sheba.health.gov.il
authors.forename: Ben-Ami
authors.initials: BA
authors.lastname: Sela
authors.forename: Ram
authors.initials: R
authors.lastname: Doolman
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011498:Protein Precursors / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D011498:Protein Precursors; D017430:Prostate-Specific Antigen