前列腺特异性抗原前体用于前列腺癌早期诊断

1112Vol.11No.12200512NationalJournalofAndrologyDec.20051,1;2(,1.,2.,210002):PSA(proPSA)PSA,proPSA,[22]proPSA[24]proPSA(PCa)[27]proPSA[25]proPSA,[22]proPSAPCa,PSA4g/LproPSAPCa:PSA;;:R446.62;R737.25:A:100923591(2005)1220944203RecentAdvancesinproPSAonEarlyDetectioninProstateCancerZHUPei2yuan1,HONGPing1,HUANGYu2feng21.LaboratoryofImmunohematology,2.LaboratoryofReproduction&Genetics,NanjingGeneralHospitalofNanjingCommand,PLA,Nanjing,Jiangsu210002,ChinaCorrespondenceto:ZHUPei2yuan,E2mail:[e-mail]:Theprecursorofprostatespecificantigen(proPSA)aredistinctmolecularformsoffreePSAinserum.proPSAiscomprisedofnativeproPSAaswellasseveraltruncatedforms,inwhich[22]proPSAand[24]proPSAaremoreprostatecancer(PCa)2associatedthan[27]proPSAand[25]proPSA.Clinicalstudieshaverecentlyprovidedevidencethat[22]proPSAcansignificantlyimprovethede2tectionofPCa,particularlyinpatientswithtotalserumPSAvalueslessthan4g/L.Inthispaper,themechanismandcharacteristicsofproPSAformationandimpactofproPSAontheearlydetectionofPCaarereviewed.NatlJAndrol,2005,11(12):9442946Keywords:proPSA;prostatecancer;earlydetection(prostatecancer,PCa),(prostatespecificanti2gen,PSA),PSAPCa,[1]PSA(tPSA),70%90%12(ACT),PSA(cP2SA);10%30%PSA(fPSA),tPSA4.0g/LPCa,(be2nignprostatichyperplasia,BPH)PCaPSAtPSA4.110g/L,fPSA/tPSAPCaBPH,PCa,tPSA4g/LPCaPSA(precursorofprostatespecificantigen,proP2SA)PSA,PCa[2],1proPSAPSA(kallikreinfamily),19q13.4,PSApre2pro449:2005204210;:2005208215:(19702),,,,,:,E2mail:[e-mail],17(leaderse2quence)PSA,pre2proPSA,244PSA(proenzyme)proPSAproPSAN7(APLILSR)pro(pro2leaderpeptide)237PSA,proPSA2(humankallikrein2,hK2),78PSA,PSAN[3](1[4])1PSA(Peyromaure[4])Figure1.BiologicalpathwayofPSA(PeyromaureM,etal[4])fPSAPCa,fPSA,proproPSA1997,Mikolajczyk[5]PCa,PSA63g/L,(highperformancehydrophobicinter2actionchromatography,HIC2HPLC)fPSA,25%fPSA[24]proPSA(pro4),PCaproPSAproP2SA,proPSA,pro15,7[6][24]proPSA[22]proP2SAhK2,[27]proPSA[25]proPSA,hK2PSA[7],fPSA3PSA:PSA,PSA,;BPHPSA(BPH2associatedprostatespecificantigen,BPSA),PSA,BPH;proPSA,[22][24][25][27]proPSA,PCa[8]2proPSAPCa2.1proPSAPCa,proPSAPCa,PCaBPH,proPSA,[22]proPSAPCaMikolajczyk[9]PSA,PCaproPSA,[22]proPSA2001,Mikolajczyk[7][22][24][27]proPSA,tPSA10g/LWestern5PCa,[22]proPSAfPSA25%95%,3PCa6%19%,PCa[22]proPSA,[22]proPSA,hK2[27]proPSAPSA,[22]proPSA,Bangma[10]RocheproPSAELISA[27]proPSA[25]proPSA,PCa,proPSA,[22]proPSA,PCa2.2proPSAPCa,tPSA10g/L,proPSAPCaSokoll[11]tPSA2.54.0g/L119(PCa31BPH88),tPSAfPSAproPSA,proPSA[22][24][27]proPSABPHPCatPSAfPSA/PSA,proPSA/fPSA(50.1%)BPH(35.5%)Khan[12],tPSA4.010.0g/L,proPSAtPSAfPSA/tPSAPCaCatalona[13]1091PCatPSA24g/L(BPH320PCa235)410g/L(BPH315PCa221),tPSAfPSAproPSA90%,tPSA24g/LproPSA/fPSA19%,fPSAcPSA10%11%(P0.001);tPSA410g/LproPSA/fPSA31%,fPSAcPSA20%19%(P0.0001);,tPSA210g/L,proPSA/fPSA5491221%,fPSAcPSA13%9%(P0.0001),proPSAfPSAcPSAtPSAPCa,tPSA210g/L,proPSA/fPSAPCaBPH,tPSA4g/L2.3[22]proPSAPCaCatalona[14],tPSA24g/L,proPSA[22]proPSAPCaMikolajczyk[15],proPSA,tPSA410g/LPCaBPH,ROCproPSA0.0150.025g/L,PCaproPSAfPSA33%,BPH25%(P0.0001)1/3(33%)PCaproPSA40%,BPH8%(P0.0001),fPSA25%,[22]proPSAPCa,Naya[16]43PCaPCa[22][24][27]proPSA,BPSAfPSA,15T2PCa,(PV)50cm3;13T2PCa,PV25cm3;15PCa,PV50cm3proPSA[22][24][27]proPSA3fPSA/tPSA[22]proPSA/fPSA[22]proP2SA/BPSA[22]proPSA/(fPSA2BPSA)[22]proPSA/(fPSA2proPSA)[22]proPSA/[fPSA2(proPSA+BPSA)],PVPCa,PVPCa[22]proPSA/(fPSA2proPSA);[22]proPSA/fPSA,,[22]proPSA/(fPSA2proPSA)PV,PCa3,PCatPSA,tPSA,PCa,tPSAproPSAPCa[17],proPSAPCa,[4][1],,.[J].,2003,9(8):5632565,568.[2]MikolajczykSD,RittenhouseHG.ProPSA:amorecancerspe2cificformofprostatespecificantigenfortheearlydetectionofprostatecancer[J].KeioJMed,2003,52(2):86291[3]BalkSP,KoYJ,BubleyGJ.Biologyofprostate2specificantigen[J].JClinOncol,2003,21(2):3832391.[4]PeyromaureM,FullaY,DebreB,etal.ProPSA:aprocanc2erformofPSA[J]?MedHypotheses,2005,64(1):92295.[5]MikolajczykSD,GrauerLS,MillarLS,etal.AprecursorformofPSA(pPSA)isacomponentofthefreePSAinprostatecancerserum[J].Urology,1997,50(5):7102714.[6]PeterJ,UnverzagtC,KroghTN,etal.Identificationofprecursorformsoffreeprostate2specificantigeninserumofprostatecancerpatientsbyimmunosorptionandmassspectrometry[J].CancerRes,2001,61():9572962.[7]MikolajczykSD,MarkerKM,MillarLS,etal.Atruncatedpre2cursorformofprostate2specificantigenisamorespecificserummarkerofprostatecancer[J].CancerRes,2001,61():695826963.[8]MikolajczykSD,MarksLS,PartinAW,etal.Freeprostate2spe2cificantigeninserumisbecomingmorecomplex[J].Urology,2002,59(6):7972802.[9]MikolajczykSD,MillarLS,WangTJ,etal.Aprecursorformofprostate2specificantigenismorehighlyelevatedinprostatecancercomparedwithbenigntransitionzoneprostatetissue[J].CancerRes,2000,60(3):7562759.[10]BangmaCH,WildhagenMF,YurdakulG,etal.Thevalueof(27,25)pro2prostate2specificantigenandhumankallikrein22asser2ummarkersforgradingprostatecancer[J].BJUInt,2004,93(6):7202724.[11]SokollLJ,ChanDW,MikolajczykSD,etal.Proenzymepsafortheearlydetectionofprostatecancerinthe2.524.0ng/mltotalpsarange:preliminaryanalysis[J].Urology,2003,61(2):2742276.[12]KhanMA,P