High molecular weight protein biomarkers of prostate cancer. Prospects of application in modern oncourology
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Abstract
Prostate cancer (PCa) has remarkably spread among the male population of the planet and due to this is representing a grave challenge to public health in different countries. Moreover PCa is occupying the second place after lung cancer by the quantity of men’s deaths. In view of this, implementation of early diagnostics of the malignancy is of great need. The first widely used in the clinical laboratory diagnostics biomarker of PCa has become kallikrein-3 or prostate specific antigen (PSA).
Despite a number of its drawbacks, moderate sensitivity and low specificity, which have frequently stipulated the emergence of false-positive and false-negative results, PSA-testing has been widely applying over a few last decades in clinical laboratory diagnostics for PCa early detection. The further refinement of PSA-testing was ful-filled through introduction of a series of biomarkers on the basis of free PSA molecular forms along with complexed PSA, the most challenging of them being [-2]proPSA. Because of this, % [-2]proPSA and prostate health index (PHI), the latter being the product of % [-2]proPSA and √tPSA, are regarded as the most valuable criteria in PCa early diagnostics.
In the present literature review the high molecular weight protein biomarkers are discussed. As alternative ones to PSA in PCa detection the following biomolecules have been proposed, namely: kallikrein-2, prostate specific membrane antigen, α-metyl-КоА-racemase, interleukin-6, Zn-α2 glycoprotein, EN-2 protein and β-1 transforming growth factor.
It was shown that by the aid of biomarkers’ panel including urokinase plasminogen activator (uPA), receptor to uPA (uPAR) and the type 1 inhibitor of uPA (uPAI-1) tumor aggressiveness and its aptitude to recurrence and metastases can be predicted. Incidentally the need of effective biomarkers’ panels for oncourology is evident.
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