He Wei, Xiao Yutian, Yan Shi, Zhu Yasheng, Ren Shancheng
College of Basic Medical Sciences, Naval Medical University, Shanghai, China.
Department of Urology, The First Affiliated Hospital, Naval Medical University, Shanghai, China.
Asian J Urol. 2023 Jul;10(3):298-316. doi: 10.1016/j.ajur.2022.11.002. Epub 2022 Dec 9.
With the escalating prevalence of prostate cancer (PCa) in China, there is an urgent demand for novel diagnostic and therapeutic approaches. Extensive investigations have been conducted on the clinical implementation of circulating free DNA (cfDNA) in PCa. This review aims to provide a comprehensive overview of the present state of cfDNA as a biomarker for PCa and to examine its merits and obstacles for future clinical utilization.
Relevant peer-reviewed manuscripts on cfDNA as a PCa marker were evaluated by PubMed search (2010-2022) to evaluate the roles of cfDNA in PCa diagnosis, prognosis, and prediction, respectively.
cfDNA is primarily released from cells undergoing necrosis and apoptosis, allowing for non-invasive insight into the genomic, transcriptomic, and epigenomic alterations within various PCa disease states. Next-generation sequencing, among other detection methods, enables the assessment of cfDNA abundance, mutation status, fragment characteristics, and epigenetic modifications. Multidimensional analysis based on cfDNA can facilitate early detection of PCa, risk stratification, and treatment monitoring. However, standardization of cfDNA detection methods is still required to expedite its clinical application.
cfDNA provides a non-invasive, rapid, and repeatable means of acquiring multidimensional information from PCa patients, which can aid in guiding clinical decisions and enhancing patient management. Overcoming the application barriers of cfDNA necessitates increased data sharing and international collaboration.
随着中国前列腺癌（PCa）患病率的不断攀升，对新型诊断和治疗方法的需求迫在眉睫。针对循环游离DNA（cfDNA）在PCa临床应用方面已开展了广泛研究。本综述旨在全面概述cfDNA作为PCa生物标志物的现状，并探讨其在未来临床应用中的优点和障碍。
通过PubMed检索（2010 - 2022年）评估有关cfDNA作为PCa标志物的相关同行评审手稿，以分别评估cfDNA在PCa诊断、预后和预测中的作用。
cfDNA主要从经历坏死和凋亡的细胞中释放出来，从而能够对各种PCa疾病状态下的基因组、转录组和表观基因组改变进行非侵入性洞察。除其他检测方法外，新一代测序能够评估cfDNA丰度、突变状态、片段特征和表观遗传修饰。基于cfDNA的多维度分析有助于PCa的早期检测、风险分层和治疗监测。然而，仍需要对cfDNA检测方法进行标准化，以加速其临床应用。
cfDNA提供了一种从PCa患者获取多维度信息的非侵入性、快速且可重复的方法，有助于指导临床决策和加强患者管理。克服cfDNA的应用障碍需要增加数据共享和国际合作。
