新型前列腺癌诊断生物标志物：最新研究进展。
Novel Diagnostic Biomarkers of Prostate Cancer: An Update.
机构信息
Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy.
Department of Urology, Salus Clinic, Trieste, Italy.
出版信息
Curr Med Chem. 2019;26(6):1045-1058. doi: 10.2174/0929867325666180914115416.
OBJECTIVE
In recent years, several biomarkers alternative to standard prostate specific antigen (PSA) for prostate cancer (PCa) diagnosis have become available. The aim of this systematic review is to assess the current knowledge about alternative serum and urinary biomarkers for the diagnosis of PCa.
MATERIAL AND METHODS
A research was conducted in Medline, restricted to English language articles published between December 2014 and June 2018 with the aim to update previously published series on PCa biomarkers. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) criteria were used for selecting studies with the lowest risk of bias.
RESULTS
Emerging role and actual controversies on serum and urine alternative biomarkers to standard PSA for PCa diagnosis, staging and prognosis assessment, such as prostate health index (PHI), PCA3, ConfirmMDx, Aberrant PSA glycosylation, MiPS, miRNAs are critically presented in the current review.
CONCLUSION
Although the use of several biomarkers has been recommended or questioned by different international guidelines, larger prospective randomized studies are still necessary to validate their efficacy in PCa detection, discrimination, prognosis and treatment effectiveness. To date, only PHI and 4Kscore have shown clinical relevance for discriminating more aggressive PCa. Furthermore, a new grading classification based on molecular features relevant for PCa risk-stratification and tailoring treatment is still needed.
目的
近年来，已经有几种替代前列腺特异性抗原（PSA）的生物标志物可用于前列腺癌（PCa）的诊断。本系统评价旨在评估当前关于 PCa 诊断的替代血清和尿液生物标志物的知识。
材料与方法
在 Medline 中进行了一项研究，仅限于 2014 年 12 月至 2018 年 6 月期间发表的英语文章，旨在更新以前发表的关于 PCa 生物标志物的系列文章。采用系统评价和荟萃分析的首选报告项目（PRISMA）标准选择具有最低偏倚风险的研究。
结果
目前的综述批判性地介绍了替代标准 PSA 用于 PCa 诊断、分期和预后评估的血清和尿液生物标志物（如前列腺健康指数（PHI）、PCA3、ConfirmMDx、异常 PSA 糖基化、MiPS、miRNAs）的新兴作用和实际争议。
结论
尽管不同的国际指南已经推荐或质疑了几种生物标志物的使用，但仍需要进行更大规模的前瞻性随机研究来验证它们在 PCa 检测、鉴别、预后和治疗效果方面的疗效。迄今为止，只有 PHI 和 4Kscore 显示出在鉴别更具侵袭性的 PCa 方面具有临床相关性。此外，仍需要基于与 PCa 风险分层和治疗定制相关的分子特征的新分级分类。
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