Prostate cancer (PCa) is mostly detected by prostate-specific antigen (PSA) as one of the most widely used tumor markers. But PSA is limited with its low specificity. The prostate health index (phi) can improve specificity over percent free and total PSA and correlates with aggressive cancer. The urinary PCA3 also shows its utility to detect PCa but its correlation with aggressiveness and the low sensitivity at high values are limitations. While the detection of alterations of the androgen-regulated TMPRSS2 and ETS transcription factor genes in tissue of ˜50% of all PCa patients was one research milestone, the urinary assay should only be used in combination with PCA3. Both US FDA-approved markers phi and PCA3 perform equally.
Keywords: AUC; ETS; PCA3; PSA; PSA limitations; PSA subforms; ROC analysis; TMPRSS2; cancer; free PSA; kallikreins; phi; prostate; prostate biopsy; prostate volume; sarcosine; sensitivity; specificity; tumor marker; urine.