Reference :
ELSA-PAP
Available outside the USA Prostate tumors are one of the main causes of morbidity and mortality in men older than 50. The therapy is essentially based on surgery and hormonotherapy. Early treatment of prostate cancer is essential to be effective. However, clinical signs of prostate cancer often appear late. If digital rectal examination is still important, for the diagnosis, biology is a very helpful tool. PAP (Prostatic Acid Phosphatase or orthophosphoric-monoesterphosphohydrolase acid EC 3.1.3.2) is a 100 000 daltons molecular weight glycoprotein, synthetized in prostata epithelium. Before immunoassays appeared, the PAP quantification was generally made by measuring its enzymatic activity (method of inhibition by tartrate). With the use of monoclonal antibodies, the PAP immunoradiometric assay allows better specificity and sensitivity. Though not much sensitive in early stages, the PAP is very specific and a PAP level increase should evoke a prostate cancer, in the clinical context and outside any prostatic manipulation. A prostate cancer with a high PAP level is related in more than 90 % of cases to lymph-nodes involvement.The combination of a PAP assay with a PSA assay allows a better monitoring of patients and an earlier detection of recurrences as well as a better follow-up of post therapeutic response.
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