Smits Minke, Mehra Niven, Sedelaar Michiel, Gerritsen Winald, Schalken Jack A
a Department of Urology and Oncology , Radboud Universiteit , Nijmegen , The Netherlands.
Expert Rev Mol Diagn. 2017 Aug;17(8):791-804. doi: 10.1080/14737159.2017.1345627.
Major advances through tumor profiling technologies, that include next-generation sequencing, epigenetic, proteomic and transcriptomic methods, have been made in primary prostate cancer, providing novel biomarkers that may guide precision medicine in the near future. Areas covered: The authors provided an overview of novel molecular biomarkers in tissue, blood and urine that may be used as clinical tools to assess prognosis, improve selection criteria for active surveillance programs, and detect disease relapse early in localized prostate cancer. Expert commentary: Active surveillance (AS) in localized prostate cancer is an accepted strategy in patients with very low-risk prostate cancer. Many more patients may benefit from watchful waiting, and include patients of higher clinical stage and grade, however selection criteria have to be optimized and early recognition of transformation from localized to lethal disease has to be improved by addition of molecular biomarkers. The role of non-invasive biomarkers is challenging the need for repeat biopsies, commonly performed at 1 and 4 years in men under AS programs.
通过肿瘤分析技术取得了重大进展，这些技术包括新一代测序、表观遗传学、蛋白质组学和转录组学方法，原发性前列腺癌领域已经取得了这些进展，提供了可能在不久的将来指导精准医学的新型生物标志物。涵盖领域：作者概述了组织、血液和尿液中的新型分子生物标志物，这些标志物可用作临床工具来评估预后、改进主动监测计划的选择标准以及在局限性前列腺癌中早期检测疾病复发。专家评论：局限性前列腺癌的主动监测（AS）是极低风险前列腺癌患者可接受的策略。更多患者可能从观察等待中受益，包括临床分期和分级较高的患者，然而，选择标准必须优化，并且必须通过添加分子生物标志物来改善对从局限性疾病转变为致命疾病的早期识别。非侵入性生物标志物的作用对重复活检的必要性提出了挑战，在AS计划下的男性中，通常在1年和4年时进行重复活检。
