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Biology of prostate-specific antigen
Steven P Balk1, Yoo-Joung Ko, Glenn J Bubley
1Cancer Biology Program, Hematology-Oncology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. sbalk@caregroup.harvard.edu
Summary
Prostate-specific antigen (PSA) is a key marker for prostate cancer (PCa). Measuring free PSA and proPSA forms can improve early detection and monitoring of PCa.
Area of Science:
- Biochemistry
- Oncology
- Urology
Background:
- Prostate-specific antigen (PSA) is an androgen-regulated serine protease.
- It is the most common serum marker for prostate cancer (PCa).
- PSA plays a role in semen liquefaction by cleaving semenogelin.
Purpose of the Study:
- To review the role of PSA in prostate cancer detection and management.
- To discuss the utility of different PSA forms (free PSA, proPSA) in improving diagnostic accuracy.
- To highlight PSA's ongoing investigation as a therapeutic target and its potential role in PCa pathogenesis.
Main Methods:
- Review of existing literature on PSA.
- Analysis of PSA's biochemical properties and function.
- Discussion of clinical applications and emerging research.
Main Results:
- Serum total PSA levels are elevated in PCa but overlap with non-cancerous conditions.
- Measurement of free PSA versus total PSA enhances specificity for PCa detection.
- Developing tests for proPSA forms may further improve early PCa detection.
Conclusions:
- PSA screening has significantly impacted PCa presentation and management.
- Free PSA and proPSA measurements offer improved diagnostic capabilities for PCa.
- PSA remains crucial for monitoring therapy response and is being explored as a therapeutic target.