Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Department of Urology, CHRU Tours, Francois Rabelais University, Tours, France.
Curr Opin Urol. 2020 Sep;30(5):684-688. doi: 10.1097/MOU.0000000000000807.
Prostate cancer (PCa) is the most commonly diagnosed cancer in men. Poor specificity and sensitivity of total PSA often results in over and sometimes underdetection/treatment. Therefore, more specific and sensitive biomarkers for the detection and monitoring especially of clinically significant PCa as well as treatment-specific markers are much sought after. In this field, urine has emerged as a promising noninvasive source of biomarkers.
RNA-based biomarkers are the most extensively studied type of urinary nucleic acids. ERG-Score/MiPS (Mi-Prostate Score) and SelectMDx might be considered as additional parameters together with clinical and imaging modalities to decrease unnecessary biopsies. miR Sentinel Tests could make it possible to accurately detect the presence of cancer and to distinguish low-grade from high-grade disease. In men with previous negative biopsies, PCA3 may suggest the need to repeat biopsy.
The definitive role of these markers and their clinical benefit needs future validation.
前列腺癌（PCa）是男性最常见的癌症。总 PSA 的特异性和敏感性差常常导致过度诊断/治疗，有时则相反。因此，人们迫切需要更特异和敏感的生物标志物，用于检测和监测特别是临床显著的 PCa 以及治疗特异性标志物。在这一领域，尿液已成为一种很有前途的非侵入性生物标志物来源。
基于 RNA 的生物标志物是研究最广泛的尿液核酸类型。ERG 评分/ MiPS（Mi-前列腺评分）和 SelectMDx 可与临床和影像学方法一起作为额外的参数，以减少不必要的活检。miR Sentinel 检测可能使准确检测癌症的存在并区分低级别和高级别疾病成为可能。在之前活检阴性的男性中，PCA3 可能提示需要重复活检。
这些标志物的明确作用及其临床获益需要进一步验证。
