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Beyond PSA: New Serum Markers for Improved Diagnosis and Management of Prostate Cancer

Issue: Vol.4, No.2 - April 2005

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Article Type: Manuscript

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  1. Dr Kevin Mark Slawin
    MD
    Associate Professor, Scott Department of Urology, Baylor College of Medicine; Director, The Baylor Prostate Cancer
  2. Dr Shahrokh F Shariat
    Scott Department of Urology, Baylor College of Medicine; Director, The Baylor Prostate Cancer
  3. Dr Eduardo I Canto
    Scott Department of Urology, Baylor College of Medicine; Director, The Baylor Prostate Cancer
  4. Dr Michael W Kattan
    Department of Pathology, Baylor College of Medicine, and The Methodist Hospital, and Epidemiology and Biostatistics Memorial Sloan Kettering Cancer Centre, New York, NY
  5. Dr Thomas M Wheeler
    Scott Department of Urology, Baylor College of Medicine; Director, The Baylor Prostate Cancer

The discovery of PSA, and its widespread clinical use in the late 1980?s, had a profound impact on the diagnosis and management of prostate cancer. PSA is a 33-kDa serine protease that is part of the 15 member Kallikrein family. PSA, also known as human kallikrein 3, had an inauspicious initial history. It was first reported in the Journal of Forensic Science as a useful marker of human seminal plasma in the 1970?s. Gerald Murphy and colleagues first purified it from the prostate gland in 1979. Shortly thereafter, it was found to be a useful marker for prostate cancer by the same group. PSA is made primarily by the same group. PSA is made primarily by the prostatic epithelium and periurethral glands in males, but it has also been detected in endomatrium, breast cancer breast milk, and female serum. In the normal prostate, the prostatic epithelium secretes PSA into the seminal fluid, where it reaches mg/ml concentrations and contributes to the liquefactin of seminal fluid by cleaving semenogelins 1 and 2.5.

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