Alapont Alacreu J M, Navarro Rosales S, Budía Alba A, España Furió F, Morera Martínez F, Jiménez Cruz J F
Servicio de Urología, Hospital Universitario La Fe, Valencia.
Actas Urol Esp. 2008 Jun;32(6):575-88. doi: 10.1016/s0210-4806(08)73891-9.
Serum markers for prostate carcinoma are widely applied for the purpose of early detection of cancer and the differentiation between benign and malignant disease, for the pre-treatment staging of detected prostatic cancers, and for the monitoring of prostate cancer after curative or palliative therapies. Since its discovery in 1979, serum PSA has been the most powerful marker of prostate cancer, but, when used alone, PSA is not sufficiently sensitive or specific to consider it an ideal tool for the early detection or staging of prostate cancer. To optimize the use of PSA, the concepts of PSA velocity, PSA density, and age-related PSA values were developed. Moreover, the molecular forms of PSA, especially the percentage of free PSA, seem to be useful tools for the detection of prostate cancer in men with slightly elevated total PSA. Human kallikrein 2 (hK2), a serine protease closely related to PSA that also is expressed predominantly in the prostate, is a new complementary marker to PSA for early detection of prostate cancer. In this review, we examine PSA testing and its effectiveness in the diagnosis of prostate cancer. Further, we also evaluate recent literature regarding the use of hk2.
前列腺癌血清标志物被广泛应用于癌症的早期检测、良性与恶性疾病的鉴别、已检测出的前列腺癌的治疗前分期以及根治性或姑息性治疗后前列腺癌的监测。自1979年被发现以来，血清前列腺特异抗原（PSA）一直是前列腺癌最有力的标志物，但是，单独使用时，PSA的敏感性和特异性不足以使其成为前列腺癌早期检测或分期的理想工具。为了优化PSA的使用，人们提出了PSA速率、PSA密度以及年龄相关PSA值的概念。此外，PSA的分子形式，尤其是游离PSA的百分比，似乎是总PSA略有升高的男性前列腺癌检测的有用工具。人激肽释放酶2（hK2）是一种与PSA密切相关的丝氨酸蛋白酶，也主要在前列腺中表达，是用于前列腺癌早期检测的PSA新的补充标志物。在本综述中，我们研究了PSA检测及其在前列腺癌诊断中的有效性。此外，我们还评估了有关使用hK2的最新文献。
