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Isoformen des freien prostataspezifischen Antigens

Isoforms of free prostate-specific antigen

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Zusammenfassung

Die Bestimmung des prostataspezifischen Antigens (PSA) ist in der Frühdiagnostik des Prostatakarzinoms nach wie vor von zentraler Bedeutung. Ein ungelöstes Problem ist jedoch die geringe Spezifität dieses organ- aber nicht karzinomspezifischen Serummarkers, die bei einer hohen Anzahl von Patienten zu weiterer, dann invasiver Diagnostik führt, ohne dass ein Prostatakarzinom gefunden wird. Die Bestimmung des Freien PSA-Anteils und die Ratio aus freiem zu Gesamt-PSA konnten zwar eine signifikante Verbesserung der Spezifität bei hoher Sensitivität erzielen, allerdings ist der Anteil von Patienten die trotz dieser Verbesserung noch weiterer Diagnostik bedürfen noch immer erheblich.

In diesem Zusammenhang ist die zunehmende Kenntnis der Isoformen des freien PSA ein Schwerpunkt der Forschung. Isoformen des freien PSA sind Varianten des nicht komplexierten, im Serum zirkulierenden PSA, etwa Vorstufen, intern gespaltene Varianten oder sog. intakte Formen, die nach gegenwärtigem Stand der Literatur zum Teil karzinomassoziiert sind zum anderen Teil aber bei benignen Prozessen hervortreten. In dieser Übersicht werden die wesentlichen Isoformen in ihren Eigenschaften und klinischen Anwendungen beschrieben.

Abstract

Detection of prostate-specific antigen remains the mainstay in the early detection of prostate cancer. A problem yet unsolved is the lack of specificity of this organ- but not cancer-specific marker, which generates subsequent, invasive procedures in a high number of patients without detecting prostate cancer. While the separate detection of free PSA and the ratio of free to total PSA has significantly improved specificity while maintaining high sensitivity, the number of patients undergoing unnecessary further diagnostics is still of concern.

In this context, the evolving knowledge on isoforms of free PSA is a major focus of current research. Isoforms of free PSA are variants of free PSA that circulate, e.g., as precursor forms, internally cleaved variants of intact molecules, and are suggested to be either more associated with cancer or more with benign diseases. This article describes biochemical and clinical properties of the isoforms of free PSA

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Authors and Affiliations

  1. Urologischen Klinik und Poliklinik, Universitätskrankenhaus Eppendorf, Hamburg

    A. Haese, T. Steuber & H. Huland

  2. Urologische Klinik, Marienhospital Herne

    J. Noldus

  3. The Department of Clinical Laboratories, Clinical Chemistry Services, Memorial Sloan-Kettering Cancer Center, New York/NY, USA

    H. Lilja

  4. Urologische Klinik und Poliklinik, Universitätskrankenhaus Eppendorf, Martinistraße 52, 20246, Hamburg

    A. Haese

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  1. A. Haese
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  3. T. Steuber
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  4. H. Huland
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  5. H. Lilja
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Correspondence to A. Haese.

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Haese, A., Noldus, J., Steuber, T. et al. Isoformen des freien prostataspezifischen Antigens. Urologe [A] 43, 675–679 (2004). https://doi.org/10.1007/s00120-004-0584-8

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  • DOI: https://doi.org/10.1007/s00120-004-0584-8

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