Balázs Katalin, Antal Lilla, Sáfrány Géza, Lumniczky Katalin
Unit of Radiation Medicine, Department of Radiobiology and Radiohygiene, National Public Health Centre, 1221 Budapest, Hungary.
J Pers Med. 2021 Apr 13;11(4):296. doi: 10.3390/jpm11040296.
Prostate cancer is among the most frequent cancers in men worldwide. Despite the fact that multiple therapeutic alternatives are available for its treatment, it is often discovered in an advanced stage as a metastatic disease. Prostate cancer screening is based on physical examination of prostate size and prostate-specific antigen (PSA) level in the blood as well as biopsy in suspect cases. However, these markers often fail to correctly identify the presence of cancer, or their positivity might lead to overdiagnosis and consequent overtreatment of an otherwise silent non-progressing disease. Moreover, these markers have very limited if any predictive value regarding therapy response or individual risk for therapy-related toxicities. Therefore, novel, optimally liquid biopsy-based (blood-derived) markers or marker panels are needed, which have better prognostic and predictive value than the ones currently used in the everyday routine. In this review the role of circulating tumour cells, extracellular vesicles and their microRNA content, as well as cellular and soluble immunological and inflammation- related blood markers for prostate cancer diagnosis, prognosis and prediction of therapy response is discussed. A special emphasis is placed on markers predicting response to radiotherapy and radiotherapy-related late side effects.
前列腺癌是全球男性中最常见的癌症之一。尽管有多种治疗方案可用于其治疗，但它通常在晚期被发现为转移性疾病。前列腺癌筛查基于对前列腺大小的体格检查、血液中前列腺特异性抗原（PSA）水平以及在疑似病例中进行活检。然而，这些标志物常常无法正确识别癌症的存在，或者它们的阳性结果可能导致对原本无症状且不进展的疾病进行过度诊断和过度治疗。此外，这些标志物对于治疗反应或治疗相关毒性的个体风险几乎没有预测价值（如果有的话）。因此，需要新型的、基于液体活检（源自血液）的最佳标志物或标志物组合，它们比目前日常使用的标志物具有更好的预后和预测价值。在这篇综述中，讨论了循环肿瘤细胞、细胞外囊泡及其微小RNA含量，以及细胞和可溶性免疫及炎症相关血液标志物在前列腺癌诊断、预后和治疗反应预测中的作用。特别强调了预测放疗反应和放疗相关晚期副作用的标志物。
