[Biomarkers for prostate cancer in predicting diagnosis, staging and prognosis]

Recently, the incidence of prostate cancer in Japan has been markedly increased because of the aggressive use of serum PSA at urological clinics and/or screening. However, the limitations of serum PSA in diagnosis of prostate cancer are also well known. While the volume adjusted PSA, PSA isoforms and PSA kinetics are useful to improve the specificity of PSA in a diagnosis, their ability are still not enough to replace PSA. More importantly, there are no definitive markers to distinguish aggressive from indolent prostate cancers, and to predict outcomes after definitive therapies. With recent advances in biotechnology such as immunohistochemical staining, proteomics, tissue microarray, DNA microarray, FISH, ELISA, RT-PCR, and SELDI-TOF, many promising biomarkers have been identified and are currently under investigation and validation. However, it is unlikely that any one marker will predict perfectly the course of disease at present, so the use of nomograms that incorporate multiple predictive factors will be a realistic way to improve prostate cancer in screening and staging. We reviewed current and potential biomarkers for prostate cancer detection and staging.