期刊
CURRENT OPINION IN UROLOGY
卷 19, 期 3, 页码 221-226出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOU.0b013e32832a2d10
关键词
diagnosis; mortality reduction; prostate cancer; prostate-specific antigen; risk stratification
资金
- Fulbright Grant [68431998, 1R21CA127768-01A1]
- National Cancer Institute, The Sidney Kimmel Center for Prostate and Urologic Cancers
- Finnish Medical Foundation
- Sigrid Juselius Foundation
- NATIONAL CANCER INSTITUTE [R21CA127768] Funding Source: NIH RePORTER
Purpose of review To delineate how recent findings on prostate-specific antigen (PSA) can improve prediction of risk, detection, and prediction of clinical endpoints of prostate cancer (PCa). Recent findings The widely used PSA cut-point of 4.0 ng/ml increasingly appears arbitrary, but no cut-point achieves both high sensitivity and high specificity. The accuracy of detecting PCa can be increased by additional predictive factors and a combinations of markers. Evidence implies that a panel of kallikrein markers improves the specificity and reduces costs by eliminating unnecessary biopsies. Large, population-based studies have provided evidence that PSA can be used to predict PCa risk many years in advance, improve treatment selection and patient care, and predict the risk of complications and disease recurrence. However, definitive evidence is currently lacking as to whether PSA screening lowers PCa -specific mortality. Summary PSA is still the main tool for early detection, risk stratification, and monitoring of PCa, However, PSA values are affected by many technical and biological factors. Instead of using a fixed PSA cut-point, using statistical prediction models and considering the integration additional markers may be able to improve and individualize PCa diagnostics. A single PSA measurement at early middle age can predict risk of advanced PCa decades in advance and stratify patients for intensity of subsequent screening.
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