TY - JOUR
T1 - Clinical Use of [-2]proPSA (p2PSA) and Its derivatives (%p2PSA and prostate health index) for the detection of prostate cancer
T2 - A review of the literature
AU - Abrate, Alberto
AU - Lughezzani, Giovanni
AU - Gadda, Giulio Maria
AU - Lista, Giuliana
AU - Kinzikeeva, Ella
AU - Fossati, Nicola
AU - Larcher, Alessandro
AU - Dell'Oglio, Paolo
AU - Mistretta, Francesco
AU - Buffi, Nicolòmaria
AU - Guazzoni, Giorgio
AU - Lazzeri, Massimo
PY - 2014
Y1 - 2014
N2 - Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.
AB - Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.
KW - Diagnosis
KW - Prostate health index
KW - Prostatecancer
KW - [-2]proPSA
UR - http://www.scopus.com/inward/record.url?scp=84904397983&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904397983&partnerID=8YFLogxK
U2 - 10.4111/kju.2014.55.7.436
DO - 10.4111/kju.2014.55.7.436
M3 - Article
C2 - 25045441
AN - SCOPUS:84904397983
VL - 55
SP - 436
EP - 445
JO - Korean Journal of Urology
JF - Korean Journal of Urology
SN - 2005-6737
IS - 7
ER -