Les formes moléculaires du PSA

The use of serum zinc to prostate-specific antigen ratio as a biomarker in the prediction of prostate biopsy outcomes

AIM

To generate a combination of serum zinc (Zn) and prostate-specific antigen (PSA) in an attempt to provide better prediction of prostate biopsy outcomes with Zn/PSA ratios.

MATERIALS & METHODS

Diagnostic performances of PSA and Zn/PSA were investigated using receiver operating characteristic and the area under the curve analysis and McNemar test in 480 men. Decision curve analysis was also used to determine the net clinical benefits of the two parameters.

RESULTS

The receiver operating characteristic-area under the curve analysis established a similar diagnostic performance for both parameters. Although Zn/PSA had a higher diagnostic sensitivity, PSA was superior in terms of specificity and net clinical benefits.

CONCLUSION

Zn/PSA has no substantial superiority in the prediction of prostate biopsy outcomes.

[Emerging biomarkers for the diagnosis, staging and prognosis of prostate cancer]

The introduction and widespread adoption of prostate-specific antigen (PSA) has revolutionized the way prostate cancer is diagnosed and treated. However, the use of PSA has also led to overdiagnosis and overtreatment of prostate cancer resulting in controversy about its use for screening. PSA also has limited predictive accuracy for predicting outcomes after treatment and for making clinical decisions about adjuvant and salvage therapies. Hence, there is an urgent need for novel biomarkers to supplement PSA for detection and management of prostate cancer. A plethora of promising blood- and urine-based biomarkers have shown promise in early studies and are at various stages of development (Human kallikrein 2, Early Prostate Cancer Antigen, Transforming Growth Factor-Beta 1 and Interleukin-6, Endoglin, PCA3, AMACR and ETS Gene Fusions). In this article, we review those biomarkers and then discuss the challenges a biomarker has to undergo before it is approved in a clinical use.