Molecular diagnosis of prostate cancer: serum and urine biomarkers

Prostate cancer (PCa) is one of the most common causes of cancer death among men in over ۵۰% of the world's countries. Early diagnosis is crucial to avoid malignancy and recurrence; therefore, various diagnostic methods are developed. One of the most common approaches involves serum-based tests, including the Prostate Specific Antigen (PSA) test and related tests such as the Prostatic Health Index (PHI) and ۴Kscore. Circulating tumor cells (CTC) are another serum-based prostate cancer biomarkers which have circulated in the bloodstream as a result of tumor metastasis. PSA is a prostate-specific antigen which typically rise in most prostate cancer patients. However, it can be an unreliable biomarker because some patients with prostate cancer may have normal PSA levels, while others with benign prostatic conditions like prostatitis (inflammation of the prostate) or Benign Prostate Hyperplasia (BPH) may exhibit elevated PSA. Consequently, some novel types of PSA tests like PHI and ۴Kscore (which measure different types of PSA) and urine-based tests such as Prostate Cancer Antigene۳ (PCA۳), TMPRSS۲-ERG gene fusion, ExoDx, and others have been developed to improve diagnostic accuracy. Research shows that the combination of TMPRSS۲-ERG gene fusion and PCA۳ tests, increases the specificity and sensitivity of prostate cancer diagnosis. Also, the ExoDx test analyses cancer-specific genomic biomarkers (such as PCA۳ and ERG) found in the urine. Moreover, microRNAs (miRNAs) are another significant biomarkers in prostate cancer diagnosis and prognosis. MicroRNAs are non-coding RNAs that are dysregulated in prostate cancer as they have a crucial role in tumorigenesis and development of cancer. This review highlights the molecular mechanisms of PSA and PCA۳, along with other serum and urine biomarkers applied in prostate cancer diagnosis. It also deals with other critical diagnostic biomarkers that enhance diagnostic accuracy. Understanding the mechanistic activity of these biomarkers can open the way for developing more reliable and effective diagnostic and therapeutic strategies for this type of cancer.

کلیدواژه ها:

prostate cancer ، PSA ، PCA۳ ، TMPRSS۲-ERG gene fusion ، ExoDx