Meissner V H, Jahnen M, Herkommer K
Klinik und Poliklinik für Urologie, Universitätsklinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
Urologe A. 2021 May;60(5):567-575. doi: 10.1007/s00120-021-01491-y. Epub 2021 Mar 15.
Twenty percent of all prostate cancer patients have a positive family history (at least 1 first-degree relative with prostate cancer) and a part of these patients have a genetic predisposition.
A literature search and analysis of studies investigating incidence, diagnosis, and clinical course of familial compared to sporadic prostate cancer as well as genetic predisposition was performed using PubMed and Embase.
Risk of prostate cancer depends on number, degree of relationship, and age of onset of affected men in the family. The incidence of familial prostate cancer is higher and the age of diagnosis lower compared to sporadic cases. The clinical course of the disease is comparable, but in individuals with a germline mutation, more intensive therapy is needed due to a more aggressive disease.
Crucial for risk assessment is a detailed family history, including creation of a pedigree with cancer family history if necessary. In high-risk families, genetic counselling and annual prostate-specific antigen (PSA) screening beginning at the age of 40 should be performed. Verification of a germline mutation requires more intensive therapy due to more aggressive disease.
所有前列腺癌患者中有20%有阳性家族史（至少有1名患前列腺癌的一级亲属），其中部分患者有遗传易感性。
使用PubMed和Embase对研究家族性前列腺癌与散发性前列腺癌的发病率、诊断和临床病程以及遗传易感性的研究进行文献检索和分析。
前列腺癌风险取决于家族中受影响男性的数量、亲属关系程度和发病年龄。与散发性病例相比，家族性前列腺癌的发病率更高，诊断年龄更低。疾病的临床病程相似，但对于有生殖系突变的个体，由于疾病更具侵袭性，需要更积极的治疗。
详细的家族史对风险评估至关重要，必要时包括创建有癌症家族史的家系图。在高危家族中，应从40岁开始进行遗传咨询和每年一次的前列腺特异性抗原（PSA）筛查。由于疾病更具侵袭性，生殖系突变的确诊需要更积极的治疗。
