Publication: Polimorfismos en el gen de la calicreína humana 2 (KLK2) y el desarrollo de cáncer de próstata. Relación con la proteína glandular humana 2(HK2) y las formas libre, total y ligada del PSA
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2017-10-03
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Universidad Complutense de Madrid
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Abstract
El cáncer de próstata es uno de los tumores más prevalentes en España y uno de los más frecuentemente diagnosticados en el mundo desarrollado. Se trata de un tumor que progresa de manera indetectable y, en muchas ocasiones, las manifestaciones clínicas sólo aparecen cuando la enfermedad es sistémica. Por lo tanto, se trata de un importante problema de salud pública ante el cual se han desarrollado programas de cribado para el diagnóstico precoz. El antígeno prostático específico (PSA) es el marcador tumoral más utilizado para la detección del cáncer de próstata. Sin embargo, la extendida aplicación del PSA como screening ha derivado en un aumento del número de biopsias transrectales muchas de ellas con resultado benigno y que por tanto podrían haberse evitado con el correspondiente ahorro de costes y efectos secundarios. El PSA no es específico del cáncer de próstata y pese a que se considere un marcador tumoral efectivo y órgano específico, su aumento no siempre significa que exista cáncer de próstata. Por esta razón, se han desarrollado múltiples parámetros diagnósticos que, basados en el PSA, mejoran la especificidad en la detección precoz de cáncer de próstata. Los principales parámetros son la densidad del PSA, velocidad del PSA y las formas moleculares del PSA (libre, total y ligado) Varios estudios han analizado el papel de la glicoproteína hK2 en el diagnóstico de cáncer de próstata. Es una proteasa sérica perteneciente a la misma familia del PSA. Comparten un 80% de secuencia, ambas se expresan en el epitelio prostático y están presentes en el suero y líquido seminal .Usado en combinación con el PSA libre y total se puede obtener una mejor diferenciación entre la hiperplasia benigna de próstata y el cáncer. También se ha identificado en varios trabajos que la hK2 puede asociarse a peor diferenciación tumoral, extensión extracapsular y recidiva bioquímica en pacientes operados mediante prostatectomía radical...
Prostate cancer is one of the most prevalent tumors in Spain and one of the most frequently diagnosed in the developed world. This is a tumor that progresses from undetectable way and, in many cases, the clinical manifestations appear only when the disease is systemic. Therefore, it is a major global public health problem, to which have been developed screening programs for early diagnosis. Prostate specific antigen (PSA) is the most widely used tumor marker for prostate cancer detection. However, widespread implementation of PSA screening has resulted in an increased number of unnecessary transrectal biopsies. The PSA is not specific for prostate cancer and even though a tumor marker specific organ cash and considered, the increase does not always mean there is prostate cancer. Therefore, we have developed multiple diagnostic parameters, based on PSA, to improve specificity in the early detection of prostate cancer. The main parameters are the PSA density, PSA velocity and PSA molecular forms (free, total and unbound) Several studies have examined the role of glycoprotein hK2 in the diagnosis of prostate cancer. It is one belonging to the same family of serine protease PSA. Share 80% sequence, both are expressed in the prostate epithelium and are present in serum and seminal fluid .Used in combination with the free and total PSA can get a better differentiation between benign prostatic hyperplasia and cancer. It has also been identified in several studies that hK2 can predict worse tumor differentiation, extracapsular extension and biochemical recurrence in patients undergoing radical prostatectomy. It has now been developed a statistical model that can predict the outcome of the biopsy combining free, total and intact PSA with hK2 in patients with recent PSA screening. Using this model could substantially reduce the number of unnecesary prostate biopsies...
Prostate cancer is one of the most prevalent tumors in Spain and one of the most frequently diagnosed in the developed world. This is a tumor that progresses from undetectable way and, in many cases, the clinical manifestations appear only when the disease is systemic. Therefore, it is a major global public health problem, to which have been developed screening programs for early diagnosis. Prostate specific antigen (PSA) is the most widely used tumor marker for prostate cancer detection. However, widespread implementation of PSA screening has resulted in an increased number of unnecessary transrectal biopsies. The PSA is not specific for prostate cancer and even though a tumor marker specific organ cash and considered, the increase does not always mean there is prostate cancer. Therefore, we have developed multiple diagnostic parameters, based on PSA, to improve specificity in the early detection of prostate cancer. The main parameters are the PSA density, PSA velocity and PSA molecular forms (free, total and unbound) Several studies have examined the role of glycoprotein hK2 in the diagnosis of prostate cancer. It is one belonging to the same family of serine protease PSA. Share 80% sequence, both are expressed in the prostate epithelium and are present in serum and seminal fluid .Used in combination with the free and total PSA can get a better differentiation between benign prostatic hyperplasia and cancer. It has also been identified in several studies that hK2 can predict worse tumor differentiation, extracapsular extension and biochemical recurrence in patients undergoing radical prostatectomy. It has now been developed a statistical model that can predict the outcome of the biopsy combining free, total and intact PSA with hK2 in patients with recent PSA screening. Using this model could substantially reduce the number of unnecesary prostate biopsies...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 19/01/2016