Prostate-specific membrane antigen (PSMA): Current benefits and future value

We will review the evolution, benefits, and limitations of PSMA testing in the past, its well as its current and future value. Prostate cancer has bee n the most frequently diagnosed cancer and the second leading cause of canc er death in men in the United States. It has a wide spectrum of biological behavior between latent (indolent) and progressive (aggressive). Further id entification of prostate-specific membrane antigen (PSMA) as a prognostic p roliferation marker may enhance our understanding-of the types of prostate cancer. A review of PSMA testing in the past as well as currently was condu cted. Studies were reviewed that deal with detection of PSMA in serum and s eminal fluid, reverse transcriptase-polymerase chain reaction (RT-PCR), imm unoscintigraphy, and immunohistochemical assays. PSMA is expressed primaril y in benign and cancerous prostatic epithelial cells. It is up-regulated in hormone resistant states, and in metastatic situations or other clinical s ituations where there is tumor recurrence or extension. Based on current re sults, PSR IA detected in the serum by western blotting can assist in the i dentification, staging, and monitoring of metastatic prostate cancer. In ad dition, PSMA shows a promising role in directed imaging and therapy of recu rrent or metastatic disease. (C) 2000 Wiley-Liss, Inc.