Volume 10, Number 1Review ArticlesClinical Utility of Prostate Carcinoma Molecular Diagnostic TestsDiagnostic UpdateScott B ShappellInstead of relying on serum prostate-specific antigen (PSA) to identify patients for prostate biopsy, new laboratory tests are needed that have improved specificity for prostate carcinoma (CaP), allow accurate classification of clinically insignificant CaPs, allow for detection of clinically significant CaP in patients without elevated serum PSA, and allow for identification of aggressive forms of CaP, which may warrant adjunctive or even molecularly targeted therapy in the future. Over the last several years, highthroughput gene expression profiling and proteinomics have led to the identification of genes and proteins that are specifically overexpressed in CaP. Molecular diagnostic techniques readily translated to the clinical laboratory have been incorporated into the development of new tests based on these novel molecular alterations in CaP. Some of these tests already have well-documented clinical utility, such as in facilitating prostate biopsy decisions, and are routinely available. The current review focuses on the biological, clinical, and laboratory aspects of the most promising of these current and nearfuture molecular CaP tests. [Rev Urol. 2008;10(1):44-69]Molecular diagnosticsProstate carcinomaProstate cancer antigen 3Alpha-methylacyl-CoA racemaseEarly prostate cancer antigenTransmembrane protease,serine 2ERGDNARNA
Volume 15, Number 3Review ArticlesProstate-Specific Antigen: Any Successor in Sight?Diagnostic ReviewAniebietabasi S ObortMary B AjadiOluyemi AkinloyeProstate cancer (PCa) is the most frequently diagnosed malignancy and the second leading cause of cancer death in men in the United States and other parts of the world. The lifetime risk of being diagnosed with PCa is approximately 16%. At present, the only widely accepted screening tools for PCa are prostate-specific antigen (PSA) and digital rectal examination. PSA is known to be prostate specific, but not PCa specific, and hence lacks the sensitivity to detect a large number of tumors, especially during the early stages. The PSA level is also known to be affected by many factors, such as medication, inflammation (benign prostatic hyperplasia and prostatitis), and urologic manipulation; hence, the controversy regarding the appropriate level of serum PSA that should trigger a biopsy or have clinical relevance to prostate metastases. Attempts to determine the level of prostate cells in peripheral blood by reverse transcriptase polymerase chain reaction did not significantly improve cancer diagnosis or predict postoperative failure. Therefore, the search continues for a novel biomarker or a panel of markers as well as other possible interventions to improve the use of PSA. This article reviews several possibilities. [Rev Urol. 2013;15(3):97-107 doi 10.3909/riu0567] © 2013 MedReviews®, LLCProstate-specific antigenProstate carcinomaProstate diagnostic or screening test