OCT 14, 2020 3:15 PM SGT

Tumor Markers and Prostate Cancer Screening

C.E. Credits: P.A.C.E. CE Florida CE
  • Senior Deputy Director at the European Institute of Oncology

      Doctor Deliu Victor Matei, MD, PhD, is a member of the HIFU CLINIC Medical Team, with unparalleled experience in uro oncological procedures he has personally performed over 4000 procedures including: over 2000 endoscopic procedures and over 1000 robotic procedures utilizing the groundbreaking da Vinci robotic system. Currently he works at the European Institute of Oncology in Milan, Italy (www.ieo.it) as the Head of Urology Training Activity and as the institutes premiere Robotic Surgeon He has been an Adjunct Professor at the Urological Residency School at the University of Milan's Faculty of Medicine for over 11 years and an Adjunct Professor at the Nurse University School of the Catholic University of Sacred Health. He is also a Visiting Professor at 3 major Romanian teaching facilities: the Faculty of Medicine of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj Napoca, the University of Medicine and Pharmacy in Timisoara and the “ Vasile Golds” West University in Arad.


    The use of biomarkers in screening and optimization of the diagnostic strategy may avoid unnecessary biopsies and improve the prostate biopsy performance. Screening for prostate cancer (Pca) may provide a small benefit in disease-specific mortality over 10 years but it does not improve overall mortality. These benefits should be weighed against the potential complications from biopsies and subsequent treatment, and the risk of overdiagnosis and overtreatment. PSA, if used alone, is insufficient. Integration of genomic tests may advance the diagnosis of Pca. Prostate health index, 4 kallicrein score combining PSA isoforms improve the AUC in the diagnosis setting. The genomic rearrangement occurs in about 30-50% of prostate cancer patients having a specifity of 93% and a PPV of 94%. Mi prostate score combines PCA3 with TMPRSS2 ERG to estimate risk of Pca and thus to help decision making for prostate biopsy. miRNAs seems useful tools for diagnosis and prediction of clinical outcome of Pca patients. PSA screening has to be associated with the mpMRI in order to avoid un-necessary biopsies. The circulating tumor cells identification using immuno cyto chemistry techniques seems the most promising screening test but it needs further evaluation. Integration with genomic tests (such as micro RNA) might turn out imperative in the prediction of clinical outcome.

    Learning Objectives:

    • Understand the benefits of prostate cancer screening
    • Understand the benefits of multi analyte assay panel vs one assay panel

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