Modern biomarkers in prostate cancer diagnosis

Abstract

Introduction The most common malignant neoplasm of the urinary tract is prostate cancer (PCa), which is a heterogeneous disease, ranging from very slowly developing and slightly benign to progressing, aggressive, metastatic and fatal, even when properly treated. Existing, imperfect diagnostic methods often lead to over-diagnosis and over-treatment of PCa. That is why new, better PCa biomarkers are being developed. Material and methods This review summarizes the current results of the most promising and clinically used PCa biomarkers, as well as having the potential to create new diagnostic and prognostic tools, based on the Web of Science ( www.apps.webofknowledge.com ) and Scopus ( www.scopus ) databases. com). Results Limited specificity of the prostate-specific antigen (PSA) test brings a need to develop new and better diagnostic tools. In the last few years, new approaches for providing significantly better biomarkers, an alternative to PSA, have been introduced. Modern biomarkers show improvement in being used as not only a diagnostic procedure, but also for staging, evaluating aggressiveness and managing the therapeutic process. We describe the methods recommended in the diagnosis of PCa and new PCa molecular diagnostics technologies. Individual biomarkers are used in various stages of the PCa diagnostic process, which was presented on the developed diagnostic flowchart describing the role of biomarkers in prostate cancer management. Conclusions Given the diverse nature of PCa, one diagnostic test will not answer all questions, so the use of several diagnostic methods will allow physicians to provide patients with better, personalized clinical advice.

Volatilomics: An Emerging and Promising Avenue for the Detection of Potential Prostate Cancer Biomarkers

“…PHI calculates PCa probability and is recommended for men with PSA levels between 2 and 10 ng/mL and no abnormalities in their DRE. This blood test is also able to assess the likelihood of PCa progression during active surveillance, being used to monitor patients [ 34 ]. The Four-Kallikrein (4KScore) test is a diagnostic algorithm that combines four kallikreins in blood plasma, namely human kallikrein 2 (hK2), total PSA, free PSA, intact PSA, in addition to the patient’s clinical information (age, DRE results, and prostate biopsy history).…”

“…This test assesses the probability of high-grade PCa and is recommended for patients undergoing initial and repeated biopsy. Moreover, the 4KScore also predicts the risk of occurrence and development of aggressive PCa [ 34 ]. The ExoDx Prostate IntelliScore (EPI) is a pre-biopsy RNA-based assay that uses the expression of PCA3, ERG, and SPDEF, isolated from urinary exosomes to predict the probability of high-grade PCa (Gleason score ≥ 7) on diagnostic biopsy.…”

“…The ExoDx Prostate IntelliScore (EPI) is a pre-biopsy RNA-based assay that uses the expression of PCA3, ERG, and SPDEF, isolated from urinary exosomes to predict the probability of high-grade PCa (Gleason score ≥ 7) on diagnostic biopsy. This is the only test that is not based on any other parameters related to PSA or a PSA derivative in the test algorithm to calculate the result, but clinicians can use it in conjugation with other clinical variables [ 30 , 34 ]. The SelectMDx and MyProstateScore (MPS) tests are based on the combination of multiple gene analyses.…”

“…This test combines the RNA expression levels of 31 genes involved in cell-cycle progression and 15 housekeeping genes to generate a Prolaris Score. Prolaris can be used to guide patient selection for active surveillance or definitive treatment [ 34 , 35 , 36 ]. The ProMark test is a protein-based prognostic assay of eight protein markers (DERL1, CUL2, SMAD4, PDSS2, HSPA9, FUS, phosphorylated S6, and YBOX1) that predicts the aggressiveness of cancer in patients with Gleason scores of 3 + 3 and 3 + 4.…”

A Prostate Cancer Proteomics Database for SWATH-MS Based Protein Quantification

“…The European Association of Urology (EAU-ESTRO-SIOG) [ 2 ] currently recommends analysing serum concentrations of prostate-specific antigen (PSA) with accompanying digital rectal examination (DRE) and multiparametric Magnetic Resonance Imaging (mpMRI) [ 3 ]. While PSA levels are age-stratified for diagnosis [ 4 , 5 ] its expression is organ-specific rather than tumour-specific and is frequently associated with non-neoplastic aetiology; likewise, DRE is insensitive [ 6 ]. Detection is typically related to unnecessary biopsies, which decide the final diagnosis by histological examination of the prostate gland.…”