De rol van prostaat-specifiek antigeen (PsA) en andere kallikreines in de vroege opsporing van prostaatkanker

Prostate specific antigen (PsA) is an almost ideal serum tumor marker. A small 's' is preferred in its abbreviated notation since the alleged tissue specificity steadily becomes less and less pronounced. For practical use in urological oncology this is of minor or no consequence. Even the ideal tumour marker PsA is not able to identify all clinically significant carcinomas and to distinguish those which are detected from BPH. Attemps to improve sensitivity and specificity have resulted in the identification of age-specific reference values, PsA velocity and the F/T PsA ratio as valuable adjuncts. Future developments will include assays for other members of the human kallikrein family of which PsA is a member. Molecular biological identification of prostate cancer cells in the circulation has not brought the breakthrough which initially was expected. Attention is now directed toward the role which elements of the growth hormone-IGF-1 axis may play in prostate carcinogenesis.