title: Prostate Cancer Detection and Prognosis: From Prostate Specific Antigen (PSA) to Exosomal Biomarkers.
abstract: Prostate specific antigen (PSA) remains the most used biomarker in the management of early prostate cancer (PCa), in spite of the problems related to false positive results and overdiagnosis. New biomarkers have been proposed in recent years with the aim of increasing specificity and distinguishing aggressive from non-aggressive PCa. The emerging role of the prostate health index and the 4Kscore is reviewed in this article. Both are blood-based tests related to the aggressiveness of the tumor, which provide the risk of suffering PCa and avoiding negative biopsies. Furthermore, the use of urine has emerged as a non-invasive way to identify new biomarkers in recent years, including thePCA3andTMPRSS2:ERGfusion gene. Available results about the PCA3 score showed its usefulness to decide the repetition of biopsy in patients with a previous negative result, although its relationship with the aggressiveness of the tumor is controversial. More recently, aberrant microRNA expression in PCa has been reported by different authors. Preliminary results suggest the utility of circulating and urinary microRNAs in the detection and prognosis of PCa. Although several of these new biomarkers have been recommended by different guidelines, large prospective and comparative studies are necessary to establish their value in PCa detection and prognosis.
authors: Department of Biochemistry and Molecular Genetics (CDB), Hospital Clínic, IDIBAPS, C/Villarroel, 170, 08036 Barcelona, Catalonia, Spain. xfilella@clinic.cat.
authors: Xavier
authors: X
authors: Filella
authors: Department of Biochemistry and Molecular Genetics (CDB), Hospital Clínic, IDIBAPS, C/Villarroel, 170, 08036 Barcelona, Catalonia, Spain. lfoj@clinic.cat.
authors: Laura
authors: L
authors: Foj
mesh_terms: D000818:Animals; D000951:Antigens, Neoplasm / Q000235:genetics / Q000652:urine; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood / Q000235:genetics / Q000652:urine; D055354:Exosomes / Q000473:pathology; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000032:analysis / Q000235:genetics; D050596:Oncogene Fusion; D011379:Prognosis; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000652:urine; D012697:Serine Endopeptidases / Q000235:genetics / Q000652:urine; D000071230:Transcriptional Regulator ERG / Q000235:genetics / Q000652:urine
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C072312:ERG protein, human; D035683:MicroRNAs; D000071230:Transcriptional Regulator ERG; C479341:prostate cancer antigen 3, human; D012697:Serine Endopeptidases; C421305:TMPRSS2 protein, human; D017430:Prostate-Specific Antigen
keywords: 4Kscore; PCA3 score; biomarker; exosomal biomarkers; miRNAs; prostate cancer detection; prostate health index; prostate specific antigen (PSA)