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Individual prostate-specific antigen (PSA) forms as prostate tumor markers

Becker, Charlotte LU and Lilja, Hans LU (1997) In Clinica Chimica Acta 257(1). p.117-132
Abstract
Prostate-specific antigen (PSA) is a kallikrein-like serine protease mainly expressed in the human prostate. It is responsible for the proteolysis of the gel-forming proteins in human semen. Two major extracellular protease inhibitors, alpha-1-antichymotrypsin (ACT) and alpha-2-macroglobulin (AMG) may inactivate PSA escaping from the prostate. The predominant immunodetected form of PSA in serum is complexed to ACT but PSA exists also in a free non-complexed form despite the large excess of inhibitors. The concentrations of PSA in serum are normally less than 4 micrograms/l. but elevated concentrations are found in a majority of patients with prostate cancer (CAP) and the analysis of PSA in serum has become invaluable in the detection and... (More)
Prostate-specific antigen (PSA) is a kallikrein-like serine protease mainly expressed in the human prostate. It is responsible for the proteolysis of the gel-forming proteins in human semen. Two major extracellular protease inhibitors, alpha-1-antichymotrypsin (ACT) and alpha-2-macroglobulin (AMG) may inactivate PSA escaping from the prostate. The predominant immunodetected form of PSA in serum is complexed to ACT but PSA exists also in a free non-complexed form despite the large excess of inhibitors. The concentrations of PSA in serum are normally less than 4 micrograms/l. but elevated concentrations are found in a majority of patients with prostate cancer (CAP) and the analysis of PSA in serum has become invaluable in the detection and monitoring of patients with CAP. However, it is not an ideal tumor marker in the sense that there are CAP patients with normal PSA concentrations in serum and patients with benign hyperplasia of the prostate (BPH) with elevated PSA concentrations. Analysis of the various PSA forms in serum attracts much interest as there is a higher proportion of PSA in complex with ACT in patients with CAP than in those with BPH. Optimal combinations of monoclonal antibodies have been used to design sensitive noncross-reacting immunoassays for the detection of free PSA, PSA-ACT complexes and the detection of both free PSA and PSA complexes in an equimolar fashion (i.e. total PSA). Several studies have demonstrated that the analysis of the proportions of the free-to-total PSA in serum may increase the diagnostic specificity by 15-20% without significant loss in the sensitivity for detection of CAP. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prostate-specific antigen, PSA, Human prostatic glandular kallikrein (hK-2), Prostate cancer
in
Clinica Chimica Acta
volume
257
issue
1
pages
117 - 132
publisher
Elsevier
external identifiers
  • pmid:9028629
  • scopus:0031018110
ISSN
0009-8981
DOI
10.1016/S0009-8981(96)06437-6
language
English
LU publication?
yes
id
759471dc-3e34-430f-828f-dabeac16accf (old id 1112087)
date added to LUP
2008-07-21 12:33:28
date last changed
2017-01-01 04:37:32
@article{759471dc-3e34-430f-828f-dabeac16accf,
  abstract     = {Prostate-specific antigen (PSA) is a kallikrein-like serine protease mainly expressed in the human prostate. It is responsible for the proteolysis of the gel-forming proteins in human semen. Two major extracellular protease inhibitors, alpha-1-antichymotrypsin (ACT) and alpha-2-macroglobulin (AMG) may inactivate PSA escaping from the prostate. The predominant immunodetected form of PSA in serum is complexed to ACT but PSA exists also in a free non-complexed form despite the large excess of inhibitors. The concentrations of PSA in serum are normally less than 4 micrograms/l. but elevated concentrations are found in a majority of patients with prostate cancer (CAP) and the analysis of PSA in serum has become invaluable in the detection and monitoring of patients with CAP. However, it is not an ideal tumor marker in the sense that there are CAP patients with normal PSA concentrations in serum and patients with benign hyperplasia of the prostate (BPH) with elevated PSA concentrations. Analysis of the various PSA forms in serum attracts much interest as there is a higher proportion of PSA in complex with ACT in patients with CAP than in those with BPH. Optimal combinations of monoclonal antibodies have been used to design sensitive noncross-reacting immunoassays for the detection of free PSA, PSA-ACT complexes and the detection of both free PSA and PSA complexes in an equimolar fashion (i.e. total PSA). Several studies have demonstrated that the analysis of the proportions of the free-to-total PSA in serum may increase the diagnostic specificity by 15-20% without significant loss in the sensitivity for detection of CAP.},
  author       = {Becker, Charlotte and Lilja, Hans},
  issn         = {0009-8981},
  keyword      = {Prostate-specific antigen,PSA,Human prostatic glandular kallikrein (hK-2),Prostate cancer},
  language     = {eng},
  number       = {1},
  pages        = {117--132},
  publisher    = {Elsevier},
  series       = {Clinica Chimica Acta},
  title        = {Individual prostate-specific antigen (PSA) forms as prostate tumor markers},
  url          = {http://dx.doi.org/10.1016/S0009-8981(96)06437-6},
  volume       = {257},
  year         = {1997},
}