Advances in Urinary Tumor Markers of Prostate Cancer

Prostate cancer (PCa) is currently the second most common cancer in men worldwide.The current gold standard for diagnosing PCa relies on ultrasound-guided systematic core needle biopsy after detection changes in a digital rectal examination and elevated prostate-specific antigen(PSA) level in the blood serum. Yet, serum PSA cannot reliably discriminate between benign pathologies and clinically significant forms of PCa. A common problem caused by the low specificity of this marker is over diagnosis, which leads to unnecessary biopsies and over treatment. This may be associated with various treatment complications (such as bleeding or infection) and generate unnecessary costs. Therefore, there is an urgent need for more specific and predictive biomarkers to effectively discriminate between aggressive and nonaggressive tumors and to avoid unnecessary prostate biopsies. Biomarkers derived from prostate cancer cells are released into prostatic fluids and then into urine. Urine after manipulation of the prostate is enriched with PCa biomarkers, including prostate cancer cells, DNAs, RNAs, proteins and other small molecules. In recent years, several non-invasive, cost-effective, high-accuracy urinary diagnostic biomarkers such as PSA, PCA3, MALAT1 and microRNA have been developed. This article reviews the biomarkers for the non-invasive testing of PCa in urine.