Murphy G P, Elgamal A A, Su S L, Bostwick D G, Holmes E H
Northwest Hospital, Pacific Northwest Cancer Foundation, Seattle, Washington 98125, USA.
Cancer. 1998 Dec 1;83(11):2259-69.
Current statistics indicate that prostate carcinoma is the most common form of cancer diagnosed in American men, resulting in the second highest cancer death rate. Early diagnosis and accurate staging are imperative given that there is little effective treatment for metastatic disease, especially after androgen deprivation therapy fails. Identification of new biochemical markers for disease progression will provide important tools for diagnosis and monitoring. One such potential marker is prostate specific membrane antigen (PSMA).
A review was conducted to identify reports concerning evaluation of diagnostic applications of PSMA.
PSMA is a membrane-bound glycoprotein that is highly restricted to the prostate. Immunohistochemical findings indicate that PSMA is a marker of epithelial cells of the prostate. This expression is increased in association with prostate carcinoma, particularly in hormone-refractory disease. Given its membrane-bound character, PSMA has been exploited as a marker for tumor detection by immunoscintiscanning with the 111In-labeled anti-PSMA monoclonal antibody 7E11.C5. Increased concentrations of 7E11.C5-reactive antigen are present in the serum of prostate carcinoma patients compared with healthy individuals; also, hematogenous circulating prostate carcinoma cells are detectable with reverse transcriptase-polymerase chain reaction analysis with primers specific for PSMA. New monoclonal antibodies specific for extracellular portions of the PSMA molecule currently are being utilized in applied studies.
PSMA is a widely used marker for prostate epithelial cells. Its up-regulation in association with cancer, particularly in advanced cancer, is ideal for application as a prognostic marker. A variety of promising clinical applications utilizing PSMA have been or are being developed. In the future, these promise to have an important impact on cancer diagnosis and patient treatment.
目前的统计数据表明，前列腺癌是美国男性中最常见的癌症诊断形式，导致癌症死亡率位居第二。鉴于转移性疾病几乎没有有效的治疗方法，尤其是在雄激素剥夺治疗失败后，早期诊断和准确分期至关重要。识别疾病进展的新生物化学标志物将为诊断和监测提供重要工具。一种这样的潜在标志物是前列腺特异性膜抗原（PSMA）。
进行了一项综述以识别有关PSMA诊断应用评估的报告。
PSMA是一种高度局限于前列腺的膜结合糖蛋白。免疫组织化学结果表明，PSMA是前列腺上皮细胞的标志物。这种表达与前列腺癌相关增加，特别是在激素难治性疾病中。鉴于其膜结合特性，PSMA已被用作通过用111In标记的抗PSMA单克隆抗体7E11.C5进行免疫闪烁扫描来检测肿瘤的标志物。与健康个体相比，前列腺癌患者血清中存在浓度增加的7E11.C5反应性抗原；此外，用针对PSMA的特异性引物进行逆转录聚合酶链反应分析可检测到血行循环的前列腺癌细胞。目前，针对PSMA分子细胞外部分的新型单克隆抗体正在应用研究中使用。
PSMA是一种广泛用于前列腺上皮细胞的标志物。其与癌症相关的上调，特别是在晚期癌症中，非常适合作为预后标志物应用。已经或正在开发多种利用PSMA的有前景的临床应用。未来，这些有望对癌症诊断和患者治疗产生重要影响。
