Gestor Editorial

Nuevo Usuario
Revisiones en Cáncer 00054 / http://dx.doi.org/10.20960/revcancer.00054
Resumen| PDF

Revisión

Biomarcadores en cáncer de próstata

Xavier Filella Pla

Prepublicado: 2024-01-31
Publicado: 2024-03-06
VOLUMEN 37, NÚM. 5, septiembre-octubre (2023), PAG. 227-237

Logo Descargas   Número de descargas: 20597      Logo Visitas   Número de visitas: 774      Citas   Citas: 0

Compártelo:


El antígeno específico de la próstata (PSA) es una herramienta esencial en el tratamiento de pacientes con cáncer de próstata (CaP). Su utilidad está bien establecida por las guías clínicas en el seguimiento de los pacientes con esta enfermedad, así como en el establecimiento del balance de base una vez diagnosticado el tumor. En este sentido, el PSA ofrece, junto con otras variables, como el estadio clínico y el grado de Gleason, información decisiva para la estratificación de los pacientes en función del pronóstico de la enfermedad, ayudando a seleccionar pacientes que pueden beneficiarse de ser incluidos en protocolos de vigilancia activa. Sin embargo, el cribado del CaP basado en PSA es controvertido debido a un importante sobrediagnóstico, del que resultan tratamientos innecesarios y numerosos efectos adversos. En los últimos años, varios autores han abogado por el uso de un cribado personalizado, utilizando un PSA basal, con el objetivo de superar la oposición entre cribar a todos los hombres o no cribar a nadie. Por otro lado, se han descrito nuevos biomarcadores (índice de salud prostática, 4kscore o test S3M) con el objetivo de mejorar los resultados obtenidos con el PSA.

Palabras Clave: PSA. Cribado del cáncer de próstata. PHI. 4Kscore. S3M.



Wang MC, Valenzuela LA, Murphy GP, Chu TM. Purification of a human prostate specific antigen. Invest Urol 1979;17:159-63.
Ablin RJ, Bronson P, Soanes WA, Witebsky E. Tissue- and species-specific antigens of normal human prostatic tissue. J Immunol 1970;104:1329-39.
DOI: 10.4049/jimmunol.104.6.1329
Crawford D, Waxman S. The history of Prostate Specific Antigen. En: Brawer MK, editor. Prostate Specific Antigen. New York-Basel: Marcel Dekker; 2001. p 1-8.
Yu H, Diamandis EP. Measurement of serum prostate specific antigen levels in women and in prostatectomized men with an ultrasensitive immunoassay technique. J Urol 1995;153(3 Pt 2):1004-8.
DOI: 10.1016/S0022-5347(01)67622-5
Filella X, Molina R, Alcover J, Carretero P, Ballesta AM. Detection of nonprostatic PSA in serum and nonserum samples from women. Int J Cancer 1996;68:424-7.
DOI: 10.1002/(SICI)1097-0215(19961115)68:4<424::AID-IJC4>3.0.CO;2-2
Wu ZH, Tang Y, Niu X, Pu FF, Xiao XY, Kong W. Prostatic-specific antigen (PSA) levels in patients with polycystic ovary syndrome (PCOS): a meta-analysis. Ovarian Res 2019;12(1):94.
DOI: 10.1186/s13048-019-0569-2
Stephan C, Klaas M, Müller C, et al. Interchangeability of measurements of total and free prostate-specific antigen in serum with 5 frequently used assay combinations: an update. Clin Chem 2006;52:59-64.
DOI: 10.1373/clinchem.2005.059170
Foj L, Filella X, Alcover J, JM, Escudero JM, Molina R. Variability of assay methods for total and free PSA after WHO standardization. Tumour Biol 2014;35:1867-73.
DOI: 10.1007/s13277-013-1249-2
Boegemann M, Arsov C, Hadaschik B, Herkommer K, Imkamp F, Nofer JR, et al. Discordant prostate specific antigen test results despite WHO assay standardization. Int J Biol Markers 2018;33:275-82.
DOI: 10.1177/1724600818754750
Filella X, Albaladejo MD, Allué JA, Castaño MA, Morell-García D, Ruiz MÀ, et al. Prostate cancer screening: guidelines review and laboratory issues. Clin Chem Lab Med 2019;57):1474-87.
DOI: 10.1515/cclm-2018-1252
Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan DW, Andres R, et al. Longitudinal evaluation of prostate specific antigen levels in men with and without prostate disease. JAMA 1992;267:2215-20.
DOI: 10.1001/jama.1992.03480160073037
Vickers AJ, Till C, Tangen CM, Lilja H, Thompson IM. An empirical evaluation of guidelines on prostate-specific antigen velocity in prostate cancer detection. J Natl Cancer Inst 2011;103:462-9.
DOI: 10.1093/jnci/djr028
Oesterling JE, Jacobsen SJ, Chute GG, Guess HA, Girman CJ, Panser LA, et al. Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges. JAMA 1993;270:860-4.
DOI: 10.1001/jama.1993.03510070082041
Benson MC, Whang IS, Pantuck A, Ring K, Kaplan SA, Olsson CA, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol 1992;147:815-6.
DOI: 10.1016/S0022-5347(17)37393-7
Lilja H, Christensson A, Dahlén U, Matikainen MT, Nilsson O, Pettersson K, et al. Prostate-specific antigen in serum occurs predominantly in complex with alpha-1-antichymotrypsin. Clin Chem 1991;37:1618-25.
DOI: 10.1093/clinchem/37.9.1618
Stenman UH, Leinonen J, Alfthan H, Rannikko S, Tuhkanen K, Alfthan O. A complex between Prostate-specific antigen and alfa-1-antichymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer: assay of the complex improves clinical sensitivity for cancer. Cancer Res 1991;51:222-6.
Lee R, Localio AR, Armstrong K, Malkowicz SB, Schwartz JS. A meta-analysis of the performance characteristics of the free prostate-specific antigen test. Urology 2006;67:762-8.
DOI: 10.1016/j.urology.2005.10.052
Brawer MK, Meyer GE, Letran JL, Bankson DD, Morris DL, Yeung KK, et al. Measurement of complexed PSA improves specificity for early detection of prostate cancer. Urology 1998;52:372-8.
DOI: 10.1016/S0090-4295(98)00241-6
Filella X, Alcover J, Molina R, Ballesta AM. Antígeno prostático específico y sus formas moleculares. En: Resel Estévez, Moreno Sierra J, editores. Tratado de Oncología Urológica. Tomo II. Madrid: Grupo Saned; 2003. p. 729-35.
Filella X, Truan D, Alcover J, Gutiérrez R, Molina R, Coca F, et al. Complexed prostate-specific antigen for the detection of prostate cancer. Anticancer Res 2004;24:4181-5.
D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Fondurulia J, Chen MH, et al. Clinical utility of the percentage of positive prostate biopsies in defining biochemical outcome after radical prostatectomy for patients with clinically localized prostate cancer. J Clin Oncol 2000;18:1164-72.
DOI: 10.1200/JCO.2000.18.6.1164
Mottet N, Cornford PC, Van den Bergh, RCN, Briers E, Eberli D, De Meerleer G, et al. EAU-EANM-ESTRO- ESUR- SIOG Guidelines on Prostate Cancer, 2023 [consultado el 12-01-2024]. Disponible en: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-EANM-ESTRO-ESUR-ISUP-SIOG-Guidelines-on-Prostate-Cancer-2023_2023-06-13-141145.pdf
National Canmcer Comprehensive Network. NCCN Prostate Cancer Guidelines. Version 4-2023 [consultado el 12-01-2024]. Disponible en: https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
Cooperberg MR, Meeks W, Fang R, Gaylis FD, Catalona WJ, Makarov DV. Time Trends and Variation in the Use of Active Surveillance for Management of Low-risk Prostate Cancer in the US. JAMA Netw Open 2023;6:e231439.
DOI: 10.1001/jamanetworkopen.2023.1439
Filella X. Utilidad del PSA en el cribado del cáncer de próstata en la perspectiva de la medicina personalizada. Revista de Medicina de Laboratorio 2022;3:63-73.
Chou R, Croswell JM, Dana T, Bougatsos C, Blazina I, Fu R, et al. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2011;155:762-71.
DOI: 10.7326/0003-4819-155-11-201112060-00375
Moyer VA. U.S. Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012;157:120-34.
DOI: 10.7326/0003-4819-157-2-201207170-00459
Livingston CJ, Freeman RJ, Mohammad A, Costales VC, Titus TM, Harvey BJ, et al. Choosing Wisely® in preventive medicine: the American College of Preventive Medicine’s Top 5 List of Recommendations. Am J Prev Med 2016;51:141-9.
DOI: 10.1016/j.amepre.2016.03.009
Ponencia de Cribado Poblacional de la Comisión de Salud Pública. Estado de la evidencia y recomendaciones sobre actividades de cribado en el SNS. Ministerio de Sanidad, Consumo y Bienestar social, 2019 [consultado el 14-01-2023]. Disponible en: https://www.sanidad.gob.es/areas/promocionPrevencion/cribado/docs/ActividadesDeCribadoSNS2019.pdf
Brenes Bermúdez FJ, Alcántara Montero A. ¿Detección precoz o cribado en la prevención del cáncer de próstata? Semergen 2017;43:100-8.
DOI: 10.1016/j.semerg.2016.01.014
Asociación Española de Biopatología Médica-Medicina del Laboratorio. Decisiones inteligentes desde el laboratorio: de elegir sabiamente a no hacer. Cámara Hernández V, González Pereira N (coordinadoras) Madrid: Asociación Española de Biopatología Médica-Medicina del Laboratorio; 2021 [consultado el 20-01-2023]. Disponible en:. https://www.aebm.org/images/activos/publicaciones/2021/Decisiones-inteligentes-desde-el-laboratorio-2-ed-2021_compressed.pdf
Grubb RL, Pinsky P, Prorok PC, Andriole GL. Screening for cancer: lessons learned from the prostate, lung, colorectal, and ovarian cancer screening trial. Eur Urol 2015;68:545-6.
DOI: 10.1016/j.eururo.2015.04.026
Hugosson J, Roobol MJ, Månsson M, Tammela TLJ, Zappa M, Nelen V, et al. A 16-yr follow-up of the European Randomized Study of Screening for Prostate Cancer. Eur Urol 2019;76:43-51.
DOI: 10.1016/j.eururo.2019.02.009
Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Prostate-cancer mortality at 11 years of follow-up. N Engl J Med 2012;366:981-90.
DOI: 10.1056/NEJMoa1113135
Klotz L. Overdiagnosis in urologic cancer: for World Journal of Urology Symposium on active surveillance in prostate and renal cancer. World J Urol 2022;40:1-8.
DOI: 10.1007/s00345-020-03523-2
Gulati R, Tsodikov A, Etzioni R, Hunter-Merrill RA, Gore JL, Mariotto AB, et al. Expected population impacts of discontinued prostate-specific antigen screening. Cancer 2014;120:3519-26.
DOI: 10.1002/cncr.28932
Eapen RS, Herlemann A, Washington SL 3rd, Cooperberg MR. Impact of the United States Preventive Services Task Force 'D' recommendation on prostate cancer screening and staging. Curr Opin Urol 2017;27:205-9.
DOI: 10.1097/MOU.0000000000000383
Bandini M, Mazzone E, Preisser F, Nazzani S, Zaffuto E, Marchioni M, et al. Increase in the Annual Rate of Newly Diagnosed Metastatic Prostate Cancer: A Contemporary Analysis of the Surveillance, Epidemiology and End Results Database. Eur Urol Oncol 2018;1:314-20.
DOI: 10.1016/j.euo.2018.04.013
Grossman DC, Curry SJ, Owens DK, Bibbins-Domingo K, Caughey AB, Davidson KW, et al. Screening for prostate cancer: US Preventive Services Task Force recommendation statement. JAMA 2018;319:1901-13.
DOI: 10.1001/jama.2018.3710
Stenman UH. Does PSA cause prostate cancer or prevent its growth. 5th Annual International Symposium on Kallikreins and Kallikrein-Related Peptidases, Toronto, 2013. Clin Chem Lab Med 2014; 52(7):eA21-eA48.
DOI: 10.1515/cclm-2014-0340
Stenman UH, Leinonen J, Hakama M, Knekt P, Aromaa A, Teppo L. Serum concentrations of prostate specific antigen and its complex with α1-antichymotrypsin before diagnosis of prostate cancer. Lancet 1994;344:1594-98.
DOI: 10.1016/S0140-6736(94)90405-7
Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 2011;59:61-71.
DOI: 10.1016/j.eururo.2010.10.039
Vickers AJ, Cronin AM, Björk T, Manjer J, Nilsson PM, Dahlin A, et al. Prostate specific antigen concentration at age 60 and death or metastasis from prostate cancer: case-control study. BMJ 2010;341:c4521.
DOI: 10.1136/bmj.c4521
Kovac E, Carlsson SV, Lilja H, Hugosson J, Kattan MW, Holmberg E, et al. Association of Baseline Prostate-Specific Antigen Level with Long-term Diagnosis of Clinically Significant Prostate Cancer Among Patients Aged 55 to 60 Years: A Secondary Analysis of a Cohort in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. JAMA Netw Open 2020;3:e1919284.
DOI: 10.1001/jamanetworkopen.2019.19284
Policy Paper on PSA screening for Prostate Cancer. Has the time come to reconsider structured population-based PSA screening for prostate cancer? [consultado el 24-01-2023]. Disponible en: https://www.europa-uomo.org/wp-content/uploads/2020/03/71706_EAU_policy-briefing_PSA.pdf
Gandaglia G, Albers P, Abrahamsson PA, Briganti A, Catto JWF, Chapple CR, et al. Structured Population-based Prostate-specific Antigen Screening for Prostate Cancer: The European Association of Urology Position in 2019. Eur Urol 2019;76:142-50.
DOI: 10.1016/j.eururo.2019.04.033
Van Poppel H, Hogenhout R, Albers P, van den Bergh RCN, Barentsz JO, Roobol MJ. Early Detection of Prostate Cancer in 2020 and Beyond: Facts and Recommendations for the European Union and the European Commission. Eur Urol 2021;79:327-9.
DOI: 10.1016/j.eururo.2020.12.010
Van Poppel H, Roobol MJ, Chapple CR, Catto JWF, N'Dow J, Sønksen J, et al. Prostate-specific Antigen Testing as Part of a Risk-Adapted Early Detection Strategy for Prostate Cancer: European Association of Urology Position and Recommendations for 2021. Eur Urol 2021;80:703-11.
DOI: 10.1016/j.eururo.2021.07.024
ANNEX to the Proposal for a Council Recommendation on strengthening prevention through early detection: a new EU approach on cancer screening replacing Council Recommendation 2003/878/EC [consultado el 27-01-2023]. Disponible en: https://health.ec.europa.eu/publications/annex-proposal-council-recommendation-cr-strengthening-prevention-through-early-detection-new_en
Filella X, Foj L. Emerging biomarkers in the detection and prognosis of prostate cancer. Clin Chem Lab Med 2015;53:963-73.
DOI: 10.1515/cclm-2014-0988
Parekh DJ, Punnen S, Sjoberg DD, Asroff SW, Bailen JL, Cochran JS, et al. A Multi-institutional prospective trial in the USA confirms that the 4Kscore accurately identifies men with high-grade prostate cancer. Eur Urol 2015;68:464-70.
DOI: 10.1016/j.eururo.2014.10.021
Stattin P, Vickers AJ, Sjoberg DD, et al. Improving the Specificity of Screening for Lethal Prostate Cancer Using Prostate-specific Antigen and a Panel of Kallikrein Markers: A Nested Case-Control Study. Eur Urol 2015;68:207-13.
DOI: 10.1016/j.eururo.2015.01.009
de Almeida S R Jr, Thomas J, Mason MM, Becerra MF, Merhe A, Reis IM, et al. S. Optimum threshold of the 4Kscore for biopsy in men with negative or indeterminate multiparametric magnetic resonance imaging. BJUI Compass 2023;4:591-6.
DOI: 10.1002/bco2.235
Filella X, Foj L, Wijngaard R, Luque P. Value of PHI and PHID in the detection of intermediate- and high-risk prostate cancer. Clin Chim Acta 2022;531:277-82.
DOI: 10.1016/j.cca.2022.04.992
Maxeiner A, Kilic E, Matalon J, Friedersdorff F, Miller K, Jung K, et al. The prostate health index PHI predicts oncological outcome and biochemical recurrence after radical prostatectomy - analysis in 437 patients. Oncotarget 2017;8:79279-88.
DOI: 10.18632/oncotarget.17476
Druskin SC, Tosoian JJ, Young A, Collica S, Srivastava A, Ghabili K, et al. Combining Prostate Health Index density, magnetic resonance imaging and prior negative biopsy status to improve the detection of clinically significant prostate cancer. BJU Int 2018;121:619-26.
DOI: 10.1111/bju.14098
Gnanapragasam VJ, Burling K, George A, Stearn S, Warren A, Barrett T, et al. The Prostate Health Index adds predictive value to multi-parametric MRI in detecting significant prostate cancers in a repeat biopsy population. Sci Rep 2016;6:35364.
DOI: 10.1038/srep35364
Ström P, Nordström T, Aly M, Egevad L, Grönberg H, Eklund M. The Stockholm-3 Model for Prostate Cancer Detection: Algorithm Update, Biomarker Contribution, and Reflex Test Potential. Eur Urol 2018;74:204-10.
DOI: 10.1016/j.eururo.2017.12.028
Viste E, Vinje CA, Lid TG, Skeie S, Evjen-Olsen Ø, Nordström T, et al. Effects of replacing PSA with Stockholm3 for diagnosis of clinically significant prostate cancer in a healthcare system - the Stavanger experience. Scand J Prim Health Care 2020;38:315-22.
DOI: 10.1080/02813432.2020.1802139
Grönberg H, Eklund M, Picker W, Aly M, Jäderling F, Adolfsson J, et al. Prostate Cancer Diagnostics Using a Combination of the Stockholm3 Blood Test and Multiparametric Magnetic Resonance Imaging. Eur Urol 2018;74:722-8.
DOI: 10.1016/j.eururo.2018.06.022

Artículos más populares


Editado en Madrid por:
Diseño y Desarrollo web Im3diA comunicación

Una cookie o galleta informática es un pequeño archivo de información que se guarda en su navegador cada vez que visita nuestra página web. La utilidad de las cookies es guardar el historial de su actividad en nuestra página web, de manera que, cuando la visite nuevamente, ésta pueda identificarle y configurar el contenido de la misma en base a sus hábitos de navegación, identidad y preferencias. Las cookies pueden ser aceptadas, rechazadas, bloqueadas y borradas, según desee. Ello podrá hacerlo mediante las opciones disponibles en la presente ventana o a través de la configuración de su navegador, según el caso. En caso de que rechace las cookies no podremos asegurarle el correcto funcionamiento de las distintas funcionalidades de nuestra página web. Más información en el apartado “POLÍTICA DE COOKIES” de nuestra página web.

Rechazar