Department of Urology, Skåne University Hospital Malmö, Sweden.
Acta Oncol. 2011 Jun;50 Suppl 1:76-84. doi: 10.3109/0284186X.2010.531284.
The main goal of prostate cancer tissue biomarkers is to improve diagnostic and prognostic accuracy. A particularly important question is whether the cancer needs immediate treatment or if treatment can be deferred. It is highly unlikely that a single biomarker that provides comprehensive prognostic information about a newly diagnosed prostate cancer will be forthcoming. Despite extensive research efforts, very few biomarkers of prostate cancer have been successfully implemented into clinical practice today. This can be partly explained by a lack of standardised methods for performance and interpretation of immunohistochemistry, but also by poor study design with insufficient biomaterial or inappropriate statistical analysis. Also appropriate cohorts to test prostate cancer biomarkers do not exist. It must be kept in mind that unsuccessful integration of new biomarkers in nomograms can also be explained by the good performance of the clinical and pathological base model with serum PSA as the only independent biomarker. A new biomarker must be powerful enough to improve this prediction model and not merely replace.
In this report, we focus on diagnostic and prognostic cellular biomarkers in prostate cancer, recent advances and future aspects by reviewing currently available literature.
Similar to other malignancies, the proliferation marker Ki-67 seems to be a prognostic tissue biomarker and a strong candidate for integration in prediction models. Circulating tumour cells are promising markers of response to treatments in patients with metastatic disease.
Important technical advances together with histological techniques of antibody or probes conjugated with different fluorophores will certainly improve standardisation and make immunohistochemical biomarker research more reliable and precise in the future. Cellular biomarker studies are also expected to change in the future towards a complexed individualised profiling of human tumours with integrative analysis using different technologies, genome-wide scanning and expression profiling.
前列腺癌组织生物标志物的主要目标是提高诊断和预后的准确性。一个特别重要的问题是，癌症是否需要立即治疗，还是可以推迟治疗。几乎不可能有一种单一的生物标志物能提供关于新诊断的前列腺癌的全面预后信息。尽管进行了广泛的研究，但今天只有极少数的前列腺癌生物标志物成功地应用于临床实践。这部分可以解释为缺乏标准化的免疫组织化学性能和解释方法，但也有研究设计不佳，生物材料不足或统计分析不当。也没有合适的队列来测试前列腺癌生物标志物。必须记住，新的生物标志物在列线图中的整合不成功，也可以用血清 PSA 作为唯一独立的生物标志物的临床和病理基础模型的良好表现来解释。新的生物标志物必须足够强大，以改善这种预测模型，而不仅仅是替代。
在本报告中，我们通过回顾目前可用的文献，重点介绍前列腺癌的诊断和预后细胞生物标志物、最新进展和未来方面。
与其他恶性肿瘤类似，增殖标志物 Ki-67 似乎是一种预后组织生物标志物，是整合到预测模型中的有力候选者。循环肿瘤细胞是转移性疾病患者对治疗反应的有希望的标志物。
重要的技术进步以及与不同荧光染料结合的抗体或探针的组织学技术，肯定会提高标准化程度，使未来的免疫组织化学生物标志物研究更加可靠和精确。未来，细胞生物标志物的研究也有望朝着使用不同技术、全基因组扫描和表达谱进行整合分析的复杂个体化人类肿瘤进行个体化分析。
