Suppr超能文献

前列腺癌的生物标志物:前列腺特异性抗原及其他。

Biomarkers for prostate cancer: prostate-specific antigen and beyond.

机构信息

UCD Clinical Research Centre, St. Vincent's University Hospital, Dublin 4, Ireland.

UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.

出版信息

Clin Chem Lab Med. 2020 Feb 25;58(3):326-339. doi: 10.1515/cclm-2019-0693.

Abstract

In recent years, several new biomarkers supplementing the role of prostate-specific antigen (PSA) have become available for men with prostate cancer. Although widely used in an ad hoc manner, the role of PSA in screening asymptomatic men for prostate cancer is controversial. Several expert panels, however, have recently recommended limited PSA screening following informed consent in average-risk men, aged 55-69 years. As a screening test for prostate cancer however, PSA has limited specificity and leads to overdiagnosis which in turn results in overtreatment. To increase specificity and reduce the number of unnecessary biopsies, biomarkers such as percent free PSA, prostate health index (PHI) or the 4K score may be used, while Progensa PCA3 may be measured to reduce the number of repeat biopsies in men with a previously negative biopsy. In addition to its role in screening, PSA is also widely used in the management of patients with diagnosed prostate cancer such as in surveillance following diagnosis, monitoring response to therapy and in combination with both clinical and histological criteria in risk stratification for recurrence. For determining aggressiveness and predicting outcome, especially in low- or intermediate-risk men, tissue-based multigene tests such as Decipher, Oncotype DX (Prostate), Prolaris and ProMark, may be used. Emerging therapy predictive biomarkers include AR-V7 for predicting lack of response to specific anti-androgens (enzalutamide, abiraterone), BRAC1/2 mutations for predicting benefit from PARP inhibitor and PORTOS for predicting benefit from radiotherapy. With the increased availability of multiple biomarkers, personalised treatment for men with prostate cancer is finally on the horizon.

摘要

近年来,一些新的生物标志物已经补充了前列腺特异性抗原(PSA)在前列腺癌患者中的作用。尽管 PSA 被广泛用于临时的临床诊断,但在无症状男性中使用 PSA 筛查前列腺癌的作用仍存在争议。然而,最近几个专家小组建议在普通风险人群(年龄 55-69 岁)中进行有限的 PSA 筛查,并在知情同意的情况下进行。然而,作为前列腺癌的筛查测试,PSA 的特异性有限,导致过度诊断,进而导致过度治疗。为了提高特异性并减少不必要的活检数量,可以使用一些生物标志物,如游离 PSA 百分比、前列腺健康指数(PHI)或 4K 评分,同时可以测量 Progensa PCA3 以减少先前阴性活检的男性重复活检的数量。除了在筛查中的作用外,PSA 还广泛用于诊断为前列腺癌的患者的管理,如诊断后的监测、监测治疗反应以及与临床和组织学标准结合进行复发风险分层。为了确定侵袭性和预测预后,特别是在低危或中危男性中,可以使用基于组织的多基因检测,如 Decipher、Oncotype DX(前列腺)、Prolaris 和 ProMark。新兴的治疗预测生物标志物包括 AR-V7 预测对特定抗雄激素(恩杂鲁胺、阿比特龙)无反应、BRAC1/2 突变预测对 PARP 抑制剂的获益以及 PORTOS 预测对放疗的获益。随着多种生物标志物的广泛应用,为男性提供个性化的前列腺癌治疗终于成为可能。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验