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Früherkennung von Prostatakarzinomen

Ist die Untersuchung des Serum-PSA alleine ausreichend?

Early detection of prostate cancer

Is serum PSA testing alone sufficient?

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Zusammenfassung

Die Euphorie mit dem PSA-Wert einen optimalen Tumormarker für das Prostatakarzinom zu haben, ist inzwischen von den großen Unzulänglichkeiten dieses Testsystems verdrängt worden. Erste Ergebnisse der zwei großen randomisierten kontrollierten Studien ERSPC und PLCO konnten nicht eindeutig den Nutzen der PSA-basierten Früherkennung belegen. Es gibt eine Vielzahl von Versuchen durch moderne Bildgebung oder dem Einsatz von PSA-Isoformen bzw. neuen Biomarkersystemen die Früherkennung des Prostatakarzinoms zu optimieren. Die vorliegende Arbeit gibt einen kurzen Überblick über die Möglichkeiten und Grenzen dieser Verfahren. Dabei bleibt der PSA-Wert trotz aller Probleme und Unzulänglichkeiten nach wie vor der wichtigste Parameter in der Früherkennung des Prostatakarzinoms. Ein Biomarker, der verlässlich ein therapiebedürftiges Prostatakarzinom vorhersagt, fehlt nach wie vor.

Abstract

The euphoria over PSA as an optimal marker for prostate cancer is gone. Measuring PSA levels has several deficiencies in detecting prostate cancer. First results of the randomized studies ERSPC and PLCO were not able to conclusively prove the value of PSA-based screening. Many attempts have been made to optimize early detection of prostate cancer like using modern imaging techniques or new biomarkers. This review deals with PSA isoforms und emerging biomarkers for the diagnosis of prostate cancer. Despite the inadequacies of PSA it is still the most important marker for the early detection of prostate cancer. Modern biomarkers with the ability to reliably predict aggressive prostate cancer are still missing.

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Authors and Affiliations

  1. Klinik und Poliklinik für Urologie, Uroonkologie und Kinderurologie, Universitätsklinik Essen, Essen, Deutschland

    C. Börgermann, F. vom Dorp, S. Kliner & H. Rübben

  2. Klinik und Poliklinik für Urologie, urologische Onkologie und Kinderurologie, Krankenhaus Düren gGmbH, Roonstraße 30, 52351, Düren, Deutschland

    C. Börgermann, G. Breuer & S. Kliner

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  1. C. Börgermann
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  2. F. vom Dorp
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  3. G. Breuer
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  4. S. Kliner
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  5. H. Rübben
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Correspondence to C. Börgermann.

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Börgermann, C., vom Dorp, F., Breuer, G. et al. Früherkennung von Prostatakarzinomen. Urologe 49, 1351–1355 (2010). https://doi.org/10.1007/s00120-010-2394-5

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  • DOI: https://doi.org/10.1007/s00120-010-2394-5

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