title: Prostate Specific Antigen as a Tumor Marker in Prostate Cancer: Biochemical and Clinical Aspects.
abstract: In this chapter the use of prostate specific antigen (PSA) as a tumor marker for prostate cancer is discussed. The chapter provides an overview of biological and clinical aspects of PSA. The main drawback of total PSA (tPSA) is its lack of specificity for prostate cancer which leads to unnecessary biopsies. Moreover, PSA-testing poses a risk of overdiagnosis and subsequent overtreatment. Many PSA-based markers have been developed to improve the performance characteristics of tPSA. As well as different molecular subforms of tPSA, such as proPSA (pPSA) and free PSA (fPSA), and PSA derived kinetics as PSA-velocity (PSAV) and PSA-doubling time (PSADT). The prostate health index (phi), PSA-density (PSAD) and the contribution of non PSA-based markers such as the urinary transcripts of PCA3 and TMPRSS-ERG fusion are also discussed. To enable further risk stratification tumor markers are often combined with clinical data (e.g. outcome of DRE) in so-called nomograms. Currently the role of magnetic resonance imaging (MRI) in the detection and staging of prostate cancer is being explored.
authors.affiliation: Department of Urology, Erasmus Medical Centre, Na-1710, 2040, 3000 CA, Rotterdam, Netherlands. jolandasalman@gmail.com.
authors.forename: J W
authors.initials: JW
authors.lastname: Salman
authors.affiliation: Department of Urology, Erasmus Medical Centre, Na-1710, 2040, 3000 CA, Rotterdam, Netherlands.
authors.forename: I G
authors.initials: IG
authors.lastname: Schoots
authors.affiliation: Department of Urology, Erasmus Medical Centre, Na-1710, 2040, 3000 CA, Rotterdam, Netherlands.
authors.forename: S V
authors.initials: SV
authors.lastname: Carlsson
authors.affiliation: Department of Urology, Erasmus Medical Centre, Na-1710, 2040, 3000 CA, Rotterdam, Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Jenster
authors.affiliation: Department of Urology, Erasmus Medical Centre, Na-1710, 2040, 3000 CA, Rotterdam, Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Roobol
mesh_terms: D055088:Early Detection of Cancer; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*
chemical_list: D017430:Prostate-Specific Antigen
keywords: Diagnostic tool s in prostate cancer; Free PSA; Molecular forms of PSA; PCA3; PSA -assays; PSA -density; PSA -doubling time; PSA -velocity; PSA biology; PSA cut-off value; PSA derived parameters; PSA kinetics; PSA physiology; Percent free PSA; ProPSA; Prostate; Prostate cancer; Prostate health index; TMPRSS2:ERG gene fusion; mpMRI