الفهرس 
Anatomy and Physiology of prostate.Only 14 pages are availabe for public view
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Abstract
Carcinoma of the prostate is the second leading cause of male cancer-related death in the United States and the third most common cause of death from cancer in men. Better indicators of prostate cancer presence and progression are needed to avoid unnecessary treatment, predict disease course, and develop more effective therapy. Numerous molecular markers have been described in human serum, urine, seminal fluid, and histological specimens that exhibit varying capacities to detect prostate cancer and predict disease course. However, to date, few of these markers have been adequately validated for clinical use. The purpose of this review is to examine the current status of these markers in prostate cancer and to assess the diagnostic potential for future markers from identified genes and molecules that display loss, mutation, or alteration in expression between tumor and normal prostate tissues. Early detection of prostate cancer using clinically sensitive procedures and/or tumor markers (e.g prostate-specific antigen [PSA]) is of prime importance.The main diagnostic tools used to look for evidence of prostate cancer include digital rectal examination, serum concentration of PSA, and transrectal ultrasound guided biopsies. PSA has been and remains one of the corner stones of early detection of prostate cancer. Although PSA unquestionably impacted the early detection of prostate cancer, simplicity, reproducibility, objectivily, high patient acceptance and low cost. It has low specificity (51- 91%) and low sensitivity (72-90%). This problem is especially evident in PSA ranges 4-10 ng/ml that is often called “gray zone”. Numerous studies have shown that 25-30% of men have prostate cancer. It was observed that 32% of men with BPH had elevated PSA values while 43% of men with organ confined prostate cancer had PSA level within the normal range. So PSA can give false positive test results occur when the PSA level is elevated but no cancer is actually present or false negative results with BPH, prostatitis or after rectal examination. This results was conducted to evaluate the diagnostic performance of PSA and its derivatives including several methods to improve the performance status of serum PSA testing which are: complexed PSA(cPSA), free PSA(fPSA), total PSA(tPSA), free/ total PSA(f / tPSA), complexed/total PSA(c/tPSA), PSA density, PSA velocity and age specific PSA for early detection of prostate cancer in patients with different ranges of PSA starting from 2.5-10, 4-10 and 2.5-20 ng/ml. Percent free PSAD is more specific than percent free PSA in distinguishing benign from malignant disease in men with a normal digital rectal examination and an intermediate PSA level, problems with this method include prostate volume determination by TRUS is often inaccurate. PSAV may have advantages over a single PSA measurement in differentiating between men with prostate cancer and those with benign disease. Problems with this method occur because of day to day variations in PSA, which can be up to 25% in the same individual.