Nowadays, the management of prostate cancer has become more and more challenging due to the increasing number of available treatment options, therapeutic agents, and our understanding of its carcinogenesis and disease progression. Moreover, currently available risk stratification systems used to facilitate clinical decision-making have limitations, particularly in providing a personalized and patient-centered management strategy. Although prognosis and prostate cancer-specific survival have improved in recent years, the heterogenous behavior of the disease among patients included in the same risk prognostic group negatively impacts not only our clinical decision-making but also oncological outcomes, irrespective of the treatment strategy. Several biomarkers, along with available tests, have been developed to help clinicians in difficult decision-making scenarios and guide management strategies. In this review article, we focus on the scientific evidence that supports the clinical use of several biomarkers considered by professional urological societies (and included in uro-oncological guidelines) in the diagnosis process and specific difficult management strategies for clinically localized or advanced prostate cancer.
当前，由于治疗选择、治疗药物日益增多，以及对前列腺癌发生机制与疾病进展认识的不断深入，前列腺癌的管理正面临越来越大的挑战。此外，目前用于辅助临床决策的风险分层系统存在局限性，尤其在提供个性化、以患者为中心的管理策略方面。尽管近年来预后及前列腺癌特异性生存率有所改善，但同一风险预后组内患者疾病行为的异质性，不仅对临床决策产生负面影响，也影响了不同治疗策略下的肿瘤学结局。为协助临床医生在复杂决策情境中制定管理策略，多种生物标志物及相关检测手段已相继开发。本文综述重点关注支持多种生物标志物临床应用的循证依据，这些标志物经专业泌尿外科学会认可（并纳入泌尿肿瘤指南），适用于临床局限性或进展性前列腺癌的诊断过程及特定复杂管理策略的制定。
How to Integrate Prostate Cancer Biomarkers in Urology Clinical Practice: An Update
肿瘤(癌症)患者之家