非侵入性生物标志物在前列腺癌诊断中的研究进展

Research progress of non-invasive biomarkers in the diagnosis of prostate cancer

前列腺癌(PCa)是男性最常见的癌症之一,也是癌症相关死亡的主要原因。PCa的早期筛查主要由广泛使用的血液标志物前列腺特异性抗原(PSA)检测确定,并最终通过活检来明确诊断。然而,PSA作为筛查工具缺乏足够的特异度,会造成一些不必要的前列腺穿刺检查,甚至过度治疗。近年来,已经发现多种生物标志物(包括血液和尿液)可以弥补PSA在PCa筛查中的这些局限性,包括针对血液的前列腺健康指数、4-激肽释放酶评分和针对尿液的PCa抗原3、TMPRSS2-ERG、SelectMDx、外泌体Dx等。本文对这些非侵入性生物标志物进行了综述,希望给PCa的诊断提供更多的思路,从而减少不必要的活检和过度治疗。

Prostate cancer(PCa)is one of the most common cancers among men and the leading cause of cancer-related death.Early screening for PCa is primarily determined by the widely used blood marker prostate specific antigen(PSA),and ultimately a definitive diagnosis is made by biopsy.However,PSA lacks sufficient specificity as a screening tool,resulting in some unnecessary prostate puncture tests and even overtreatment.In recent years,multiple biomarkers(both blood and urine)have been found to compensate for these limitations of PSA in PCa screening,including prostate health index,4-Kallikrein score for blood,and PCa antigen 3,TMPRSS2-ERG,SelectMDx,and Exosome Dx for urine.These non-invasive biomarkers are reviewed in this article,hoping to provide more ideas for the diagnosis of PCa and reduce unnecessary biopsies,and thus decrease overtreatment.