Szeliski Kamil, Adamowicz Jan, Gastecka Agata, Drewa Tomasz, Pokrywczyńska Marta
Ludwik Rydygier Medical College in Bydgoszcz Nicolaus Copernicus University in Toruń, Department of Regenerative Medicine Cell and Tissue Bank, Bydgoszcz, Poland.
Cent European J Urol. 2018;71(4):420-426. doi: 10.5173/ceju.2018.1762. Epub 2018 Dec 27.
Prostate cancer (PCa) is the most common type of cancer among men in Europe. Current recommendations for screening and diagnosis are based on prostate-specific antigen (PSA) measurements and the digital rectal examination (DRE). Both of them are triggers for prostate biopsy. Limited specificity of the PSA test brings, however, a need to develop new, better diagnostic tools. Several commercially available variations of the PSA test including: prostate health index (PHI), 4Kscore as well as molecular PCA3 score, have already revealed its value, lowering the number of unnecessary biopsies.
This review summarizes published results of the current most promising, clinically proven and experimentally evaluated PCa biomarkers which have potential for creation of new diagnostic tests.
In the last few years new approaches for providing significantly better biomarkers, an alternative to PSA, have been introduced. Modern biomarkers show improvement in being used as not only a diagnosis procedure, but also for staging, evaluating aggressiveness and managing the therapeutic process. The most promising group are molecular markers, among them microRNAs(miRNAs) and long noncoding RNAs (lncRNAs) are most frequent. Their superiority, over standard PSA, in predicting tumor formation in early stages, and clinically non-symptomatic metastases has been noticed. Extracellular vesicles presence in biofluids have brought focus of many research groups, indicating their potential significance. This group of nanoparticles has potential not only in diagnostic and therapy management process, but also as a potential therapeutic target.
Finding better PCa biomarkers, replacing the current PSA measurement, is firmly needed in modern urology practice.
前列腺癌（PCa）是欧洲男性中最常见的癌症类型。目前关于筛查和诊断的建议基于前列腺特异性抗原（PSA）检测和直肠指检（DRE）。这两者都是前列腺活检的触发因素。然而，PSA检测的特异性有限，因此需要开发新的、更好的诊断工具。几种市售的PSA检测变体，包括前列腺健康指数（PHI）、4K评分以及分子PCA3评分，已经显示出其价值，减少了不必要活检的数量。
本综述总结了目前最有前景、经过临床验证和实验评估的具有创建新诊断测试潜力的PCa生物标志物的已发表结果。
在过去几年中，已经引入了提供明显更好的生物标志物（PSA的替代物）的新方法。现代生物标志物不仅在用作诊断程序方面有所改进，而且在分期、评估侵袭性和管理治疗过程方面也有所改进。最有前景的一类是分子标志物，其中微小RNA（miRNA）和长链非编码RNA（lncRNA）最为常见。已经注意到它们在预测早期肿瘤形成和临床无症状转移方面优于标准PSA。生物流体中细胞外囊泡的存在引起了许多研究小组的关注，表明了它们的潜在意义。这组纳米颗粒不仅在诊断和治疗管理过程中有潜力，而且作为潜在的治疗靶点也有潜力。
现代泌尿外科实践中迫切需要找到更好的PCa生物标志物来取代目前的PSA检测。
