Prostate-specific antigen and prostate-specific antigen derivatives as predictors of benign prostatic hyperplasia progression.

Benign prostatic hyperplasia (BPH) is the most common urologic affliction in aging men, leading to adverse clinical outcomes in a significant proportion of the population. Serum prostate-specific antigen (PSA) has been established as a marker for prostate cancer for the past two decades but more recently has been recognized as an equally important marker of BPH presence and progression. Over this time, the discovery and study of multiple isoforms of PSA have led to even more sensitive and specific methods to differentiate BPH from prostate cancer. Herein we review the expression, processing, and biochemistry of PSA and its derivatives and discuss the potential of these isoforms, both individually and in combination, to serve as determinants of BPH severity and progression.