Man Yan-Gao, Mannion Ciaran, Jewett Anahid, Hsiao Yi-Hsuan, Liu Aijun, Semczuk Andrzej, Zarogoulidis Paul, Gapeev Andrei B, Cimadamore Alessia, Lee Peng, Lopez-Beltran Antonio, Montironi Rodolfo, Massari Francesco, Lu Xin, Cheng Liang
Department of Pathology, Hackensack Meridian School of Medicine, Nutley, NJ, USA.
Tumor Immunology Laboratory, Jonsson Comprehensive Cancer Center, UCLA School of Dentistry and Medicine, Los Angeles, CA, USA.
J Cancer. 2022 Oct 17;13(13):3463-3475. doi: 10.7150/jca.72973. eCollection 2022.
Over the past two decades, the global efforts for the early detection and intervention of prostate cancer seem to have made significant progresses in the basic researches, but the clinic outcomes have been disappointing: (1) prostate cancer is still the most common non-cutaneous cancer in Europe in men, (2) the age-standardized prostate cancer rate has increased in nearly all Asian and African countries, (3) the proportion of advanced cancers at the diagnosis has increased to 8.2% from 3.9% in the USA, (4) the worldwide use of PSA testing and digital rectal examination have failed to reduce the prostate cancer mortality, and (5) there is still no effective preventive method to significantly reduce the development, invasion, and metastasis of prostate cancer… Together, these facts strongly suggest that the global efforts during the past appear to be not in a correlated target with markedly inconsistent basic research and clinic outcomes. The most likely cause for the inconsistence appears due to the fact that basic scientific studies are traditionally conducted on the cell lines and animal models, where it is impossible to completely reflect or replicate the status. Thus, we would like to propose the human prostate basal cell layer (PBCL) as "the most effective target for the early detection and intervention of prostate cancer". Our proposal is based on the morphologic, immunohistochemical and molecular evidence from our recent studies of normal and cancerous human prostate tissues with detailed clinic follow-up data. We believe that the human tissue-derived basic research data may provide a more realistic roadmap to guide the clinic practice and to avoid the potential misleading from and animal studies.
在过去二十年中，全球在前列腺癌早期检测和干预方面所做的努力似乎在基础研究上取得了显著进展，但临床结果却令人失望：（1）前列腺癌仍是欧洲男性中最常见的非皮肤癌；（2）几乎所有亚洲和非洲国家的年龄标准化前列腺癌发病率都有所上升；（3）在美国，诊断时晚期癌症的比例从3.9%上升到了8.2%；（4）全球范围内前列腺特异性抗原（PSA）检测和直肠指检的应用未能降低前列腺癌死亡率；（5）仍然没有有效的预防方法能显著减少前列腺癌的发生、侵袭和转移……总体而言，这些事实强烈表明，过去全球的努力似乎没有针对明显不一致的基础研究和临床结果设定相关目标。这种不一致最可能的原因似乎是，传统的基础科学研究是在细胞系和动物模型上进行的，而这些模型无法完全反映或复制实际情况。因此，我们提议将人前列腺基底细胞层（PBCL）作为“前列腺癌早期检测和干预的最有效靶点”。我们的提议基于我们最近对正常和癌性人前列腺组织的形态学、免疫组织化学和分子证据以及详细的临床随访数据。我们相信，源自人体组织的基础研究数据可能提供一个更现实的路线图，以指导临床实践并避免细胞系和动物研究带来的潜在误导。
