Alford Ashley V, Brito Joseph M, Yadav Kamlesh K, Yadav Shalini S, Tewari Ashutosh K, Renzulli Joseph
1Department of Urology, Columbia University Medical Center, New York Presbyterian Hospital New York, NY.
Department of Urology, Brown University, Rhode Island Hospital Providence, RI.
Rev Urol. 2017;19(4):221-234. doi: 10.3909/riu0772.
Prostate cancer screening and diagnosis has been guided by prostate-specific antigen levels for the past 25 years, but with the most recent US Preventive Services Task Force screening recommendations, as well as concerns regarding overdiagnosis and overtreatment, a new wave of prostate cancer biomarkers has recently emerged. These assays allow the testing of urine, serum, or prostate tissue for molecular signs of prostate cancer, and provide information regarding both diagnosis and prognosis. In this review, we discuss 12 commercially available biomarker assays approved for the diagnosis and treatment of prostate cancer. The results of clinical validation studies and clinical decision-making studies are presented. This information is designed to assist urologists in making clinical decisions with respect to ordering and interpreting these tests for different patients. There are numerous fluid and biopsy-based genomic tests available for prostate cancer patients that provide the physician and patient with different information about risk of future disease and treatment outcomes. It is important that providers be able to recommend the appropriate test for each individual patient; this decision is based on tissue availability and prognostic information desired. Future studies will continue to emphasize the important role of genomic biomarkers in making individualized treatment decisions for prostate cancer patients.
在过去25年里，前列腺癌的筛查和诊断一直以前列腺特异性抗原水平为指导，但随着美国预防服务工作组最新的筛查建议，以及对过度诊断和过度治疗的担忧，最近出现了一波新的前列腺癌生物标志物。这些检测方法可对尿液、血清或前列腺组织进行检测，以寻找前列腺癌的分子迹象，并提供有关诊断和预后的信息。在本综述中，我们讨论了12种已获批准用于前列腺癌诊断和治疗的商业可用生物标志物检测方法。文中呈现了临床验证研究和临床决策研究的结果。这些信息旨在帮助泌尿科医生针对不同患者进行这些检测的订购和解读时做出临床决策。有许多针对前列腺癌患者的基于液体和活检的基因组检测方法，可为医生和患者提供有关未来疾病风险和治疗结果的不同信息。重要的是，医疗服务提供者能够为每个患者推荐合适的检测方法；这一决策基于组织的可获取性和所需的预后信息。未来的研究将继续强调基因组生物标志物在为前列腺癌患者做出个体化治疗决策中的重要作用。
