前列腺癌肿瘤标志物研究的新进展

New progress in prostate cancer biomarker research

前列腺癌已成为危害男性健康的最大问题之一.与其他肿瘤相比,前列腺癌具有更明显的肿瘤异质性,从而很大程度影响了肿瘤的诊断、治疗以及预后监测.因此,寻找高相关性的前列腺癌肿瘤标志物来指导穿刺、治疗方式的选择及随访观察变得尤为重要.从诊断层面来看,前列腺特异抗原的问世虽然提高了肿瘤的诊断率,但是其特异度低,可导致较多不必要的穿刺.目前通过高通量测序技术挖掘的长链非编码RNA、单核苷酸多态性及融合基因等分子已被证实与肿瘤具有相关性,同时可明显提高前列腺癌的诊断效能,具有良好的研究前景.从分子分型层面来看,传统的Gleason评分虽然能从显微镜下区分高、中、低危肿瘤,但受检测人员及技术所限,无法更为准确地对前列腺癌进行有效的分型.目前的研究结果表明,DNA水平的拷贝数变异及RNA水平的小RNA和长链非编码RNA均可预示肿瘤的进展,从而提示具有这些标志物的肿瘤具有高侵袭性,为前列腺癌分子分型的研究打下基础.虽然前列腺癌肿瘤标志物的发现仍处于起步阶段,但相信通过高通量测序及分子生物学技术的发展能挖掘更多更好的肿瘤标志物.

Prostate cancer is one of the major problems of men＇s health.It has more obvious cancer heterogeneity,affecting the diagnosis,treatment and prognosis monitoring when comparing with other cancer.Thus,cancer related biomarkers are urgently needed to guide biopsy,treatment selection and follow-up.In the aspect of diagnosis,though the emerging of prostate specific antigen can raise the rate of diagnosis to some extent,it brings more unnecessary biopsies because of its low specificity.Cancer related long noncoding RNAs,single nucleotide polymorphism and fusion genes are proved to increase the diagnostic efficiency through high-throughput sequencing techniques.In the aspect of molecular classification,traditional Gleason score can discriminate different risk level of the cancer,but it is limited by the technicians.It is reported that copy number variations from DNA level and small RNAs,long non-coding RNAs from RNA level are related with the progress of cancer,indicating the potential role in cancer molecular classification.Although we are still on the way of the initial stage in exploring prostate cancer biomarkers,more useful and promising biomarkers will be found by high-throughput sequencing and molecular biotechniques.