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New Molecular Markers of Diagnosis and Prognosis in Prostate Cancer

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Genitourinary Pathology

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Abstract

Serum prostate-specific antigen (PSA) has remained the mainstay biomarker for prostate cancer diagnosis and management since its wide spread utilization as a screening tool almost 25 years ago. Although it has led to a dramatic increase in prostate cancer detection, PSA has substantial drawbacks both with sensitivity and specificity. Detection of clinically insignificant disease is another important issue. Together, these drawbacks of PSA emphasize the need for biomarkers that can supplement PSA as a diagnostic test, provide better cancer specificity than currently available tissue-based markers, reduce the number of unnecessary biopsies, and distinguish indolent from clinically significant prostate cancer. New genomic and bioinformatics technologies have allowed the discovery and study of an expanding universe of novel tissue-, urine-, or body fluid-based biomarkers due to their higher cancer specificity and their prognostic or predictive utilities. Such efforts have also produced several notable success stories that involve rapidly moving biomarkers from the bench to the clinic. α-Methylacyl-CoA racemase (AMACR), ERG fusion protein, phosphatase and tensin homolog (PTEN), and prostate cancer antigen 3 (PCA3) are important examples of biomarkers, which have found their way from bench to clinic. This chapter summarizes selected novel promising prostate cancer biomarkers of utility for the diagnosis, biological stratification, and prognosis of prostate cancer. The biomarkers addressed in the chapter are classified based on their diagnostic and prognostic applications as well as their functions as tissue- and urine-based markers.

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Acknowledgments

We acknowledge Nallasivam Palanisamy, PhD, Michigan Center for Translational Pathology, University of Michigan for providing Fig. 9.6b; M. Carmen Frias-Kletecka, MD, LSU, for critical reading of the chapter; and Monica Brynes, graphics manager, LSU, for assistance with the images.

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  1. Department of Pathology, Division of Urologic Pathology, Miraca Life Sciences, Irving, TX, USA

    VP, Medical Director Rajal B. Shah MD

  2. Department of Pathology, LSU Health Sciences Center, New Orleans, LA, USA

    Asst. Prof. Ritu Bhalla MD

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Correspondence to Rajal B. Shah MD .

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  1. Department of Pathology, The Cleveland Clinic, Cleveland, Ohio, USA

    Cristina Magi-Galluzzi

  2. Department of Pathology, The Cleveland Clinic, Cleveland, Ohio, USA

    Christopher G. Przybycin

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Shah, R., Bhalla, R. (2015). New Molecular Markers of Diagnosis and Prognosis in Prostate Cancer. In: Magi-Galluzzi, C., Przybycin, C. (eds) Genitourinary Pathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2044-0_9

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