AMACR, caveolin-1, CD147, endoglin (CD105), human kallikrein-2, interleukin-6, PSMA, and TGF-β 1
Upregulated in PCa tissue compared to nonmalignant tissue; AMACR: upregulated in 88% of PCa, CRPC and metastasis strongly positive; CD147: overexpressed in many solid tumors; increased expression is associated with PCa progression and poor prognosis; PSMA: transmembrane glycoprotein, upregulated in PCa tissue compared to benign tissue; TGF- 1: growth factor; increased expression correlates with tumor invasion, metastasis and biochemical recurrence; human kallikrein-2: serine protease activates pro-KLK3 to its active form (PSA)
TMPRSS2-ERG gene fusion: expressed in malignant prostate tissue, independent marker of disease progression and poor prognosis; BRCA1/2 are tumor suppressors; BRCA2 mutation is associated with aggressive PCa and poor survival outcome
GSTP1 hypermethylation was detected in 90% of prostate cancer; RASSF1A is a tumor suppressor gene; RASSF1A hypermethylation has been observed in 60–74% of PCa and in 18.5% of BPH
Detection of TMPRSS2:ERG fusion transcript in urinary sediments, obtained after DRE (specificity 93%), combined test: PCA3 score + TMPRESS2:ERG fusion in urine after DRE—improved sensitivity from 66% (PCA3 alone) to 73% (combined)
GSTP1 hypermethylation was found in postprostate massage urine sediments of 68% of PCa patients with early confined disease, 78% of patients with locally advanced PCa, 29% of patients with PIN, and 2% of patients with BPH.
Detection of CTCs in blood has the potential to evaluate disease progression and for monitoring of therapy response. The Veridex CellSearch Assay has received FDA approval for the enumeration of CTCs in prostate cancer.
Exosomes, apoptotic bodies, microvesicles, and prostasomes
Extracellular vesicles are cell-derived vesicles that can be isolated from urine and blood and have the potential as biomarker for PCa. They also contain specific DNA, RNA, and protein molecules that are unique to the cells they originate of, and these could also serve as biomarker(s).