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Biomarkers That Differentiate Benign Prostatic Hyperplasia from Prostate Cancer: A Literature Review

Authors McNally CJ, Ruddock MW, Moore T, McKenna DJ

Received 22 February 2020

Accepted for publication 9 April 2020

Published 1 July 2020 Volume 2020:12 Pages 5225—5241


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Christopher J McNally,1,2 Mark W Ruddock,1 Tara Moore,2 Declan J McKenna2

1Randox Laboratories Ltd, Crumlin, Co. Antrim BT29 4QY, Northern Ireland; 2Biomedical Sciences Research Institute, Ulster University, Coleraine BT52 1SA, Northern Ireland

Correspondence: Declan J McKenna Tel +44 2870124356

Abstract: Prediction of prostate cancer in primary care is typically based upon serum total prostate-specific antigen (tPSA) and digital rectal examination results. However, these tests lack sensitivity and specificity, leading to over-diagnosis of disease and unnecessary, invasive biopsies. Therefore, there is a clinical need for diagnostic tests that can differentiate between benign conditions and early-stage malignant disease in the prostate. In this review, we evaluate research papers published from 2009 to 2019 reporting biomarkers that identified or differentiated benign prostatic hyperplasia (BPH) from prostate cancer. Our review identifies hundreds of potential biomarkers in urine, serum, tissue, and semen proposed as useful targets for differentiating between prostate cancer and BPH patients. However, it is still not apparent which of these candidate biomarkers are most useful, and many will not progress beyond the discovery stage unless they are properly validated for clinical practice. We conclude that this validation will come through the use of multivariate panels which can assess the value of biomarker candidates in combination with clinical parameters as part of a risk prediction calculator. Implementation of such a model will help clinicians stratify patients with prostate cancer symptoms in primary care, with tangible benefits for both the patient and the health service.

Keywords: prostate cancer, benign prostatic hyperplasia, biomarkers, differentiation, transrectal ultrasound-guided biopsy

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