Department of Urology, Meir Medical Center, Kefar Sava, 4428164, Israel; email:
Department of Urology, Princess Alexandra Hospital and Australian Prostate Cancer Research Center, Queensland University of Technology, Brisbane, Queensland, Australia; email:
Annu Rev Med. 2016;67:119-35. doi: 10.1146/annurev-med-060413-112226. Epub 2015 Oct 29.
A major dilemma in the selection of treatment for men with prostate cancer is the difficulty in accurately characterizing the risk posed by the cancer. This uncertainty has led physicians to recommend aggressive therapy for most men diagnosed with prostate cancer and has led to concerns about the benefits of screening and the adverse consequences of excessive treatment. Genomic analyses of prostate cancer reveal distinct patterns of alterations in the genomic landscape of the disease that show promise for improved prediction of prognosis and better medical decision making. Several molecular profiles are now commercially available and are being used to inform medical decisions. This article describes the clinical tests available for distinguishing aggressive from nonaggressive prostate cancer, reviews the new genomic tests, and discusses their advantages and limitations and the evidence for their utility in various clinical settings.
在选择前列腺癌男性患者的治疗方法时，一个主要的困境是难以准确描述癌症带来的风险。这种不确定性导致医生建议对大多数被诊断为前列腺癌的男性进行积极治疗，并引发了对筛查的益处和过度治疗的不良后果的担忧。前列腺癌的基因组分析揭示了疾病基因组景观中明显的改变模式，这为改善预后预测和更好的医疗决策提供了希望。目前有几种分子谱已商业化，并被用于为医疗决策提供信息。本文描述了用于区分侵袭性和非侵袭性前列腺癌的临床检测方法，回顾了新的基因组检测方法，并讨论了它们的优势和局限性，以及它们在各种临床环境中的应用证据。
