When the Prostate Specific Antigen (PSA) was introduced, its usefulness as a screening and diagnostic tool was persuasive. As with all tumor markers, some of this gloss has faded: PSA is indeed prostate, but not cancer-specific and is also elevated in benign prostatic hypertrophy, inflammation of the prostate and localized carcinoma. Determination of the ratio of free, non-complexed PSA (fPSA) to total PSA (tPSA, the sum of free and PSA complexed mainly to alpha-1-antichymotrypsin, ACT) has improved the ability of this test to discriminate between benign and malignant conditions, but is not perfect. The need for a further and additional parameter for the correct diagnosis and staging of prostate cancer has led to the introduction and evaluation of Human Glandular Kallikrein 2 (hK2) as an additional marker.
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