Prostate tumor marker research and development

Prostate tumor marker research and development

Prostate cancer is the most common tumor in the male urogenital system. In Europe and the United States, its incidence rate is second only to lung cancer and ranks second among male malignant tumors. In my country, it has also been on the rise in recent years. Currently, the diagnosis methods for this disease include digital rectal examination (DRE), imaging, cytopathology and tumor marker examination, and people pay more attention to the research of pSA markers.

Prostatic acid phosphatase (pAp)

pAp in male serum is mainly derived from the prostate. The enzyme is significantly elevated in the serum of patients with prostate cancer. In the past few decades, pAp has been used as a tumor marker for prostate cancer. However, after the widespread use of prostate-specific antigen (pSA), due to its specificity, sensitivity and greater practical value, the use of pAp has gradually faded and is now rarely used.

Prostate-specific antigen (pSA)

The discovery of pSA was in the late 1960s. During the study of immunocontraception, it was found that prostate fluid and semen contained a semen-specific protein with a molecular weight of about 30,000. In 1979, this protein was purified from prostate tissue and named pSA.

Characteristics pSA is a single-chain glycoprotein secreted by prostate epithelial cells, with chymotrypsin activity. The pSA content in semen is relatively high. Only trace amounts of pSA (0-4 ng/ml) can be detected in normal male serum, and its concentration in semen is about 1 million times that of serum (0.5-5.5 mg/ml). There is a barrier between the prostate acinar contents (rich in pSA) and the lymphatic system composed of the endothelium, basal cell layer and basement membrane. When tumors or other lesions destroy this barrier, the acinar contents can leak into the lymphatic system and then enter the blood circulation, leading to an increase in peripheral blood pSA levels.

There is a close relationship between blood pSA level and prostate disease. Studies have shown that pSA is tissue-specific to the prostate, but not specific to benign or malignant prostate diseases. Even slight damage can cause elevated serum pSA levels in prostate cancer, prostate hyperplasia, prostatitis, acute urinary retention, various prostate surgical operations, and various prostate examinations (such as DRE). Each gram of increased prostate tissue can increase serum pSA levels by 0.3 ng/ml, while prostate cancer tissue can increase it by 3.5 ng/ml, a difference of 10 times.