Current Urology Reports

, Volume 5, Issue 3, pp 231–240

Prostate-specific antigen and related isoforms in the diagnosis and management of prostate cancer

  • Alexander Haese
  • Markus Graefen
  • Hartwig Huland
  • Hans Lilja
Article

DOI: 10.1007/s11934-004-0042-6

Cite this article as:
Haese, A., Graefen, M., Huland, H. et al. Curr Urol Rep (2004) 5: 231. doi:10.1007/s11934-004-0042-6

Abstract

Despite its unparalleled merits for prostate cancer detection and staging, prostate-specific antigen (PSA) is not a marker for prostate cancer only, but also is expressed in benign conditions. For early detection, limitations of PSA are obvious. Its widespread use has led to an extensive amount of expensive and often unnecessary diagnostic procedures associated with significant morbidity. Total PSA derivatives may enhance the accuracy of prostate cancer diagnosis. The ratio of free-to-total PSA improves specificity while maintaining a high sensitivity for prostate cancer detection for men with a total PSA of 2.5 to 10 ng/mL. Human glandular kallikrein also has the potential to be a valuable tool in combination with total and free PSA for early diagnosis of prostate cancer. Complex PSA seems to be a reliable tool to improve specificity at high sensitivity levels in men with suspected prostate cancer (mainly in PSA levels below 4 ng/mL). Newly discovered isoforms of free PSA also may impact early detection of prostate cancer with encouraging preliminary results that warrant further clinical investigation.

Copyright information

© Current Science Inc 2004

Authors and Affiliations

  • Alexander Haese
    • 1
  • Markus Graefen
  • Hartwig Huland
  • Hans Lilja
  1. 1.Department of UrologyUniversity Clinic Hamburg-EppendorfHamburgGermany

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