Prostate cancer is the most common non-cutaneous cancer among men in the UK, causing significant health and economic burdens. Diagnosis and risk prognostication can be challenging due to the genetic and clinical heterogeneity of prostate cancer as well as uncertainties in our knowledge of the underlying biology and natural history of disease development. Urinary extracellular vesicles (EVs) are microscopic, lipid bilayer defined particles released by cells that carry a variety of molecular cargoes including nucleic acids, proteins and other molecules. Urine is a plentiful source of prostate-derived EVs. In this narrative review, we summarise the evidence on the function of urinary EVs and their applications in the evolving field of prostate cancer diagnostics and active surveillance. EVs are implicated in the development of all hallmarks of prostate cancer, and this knowledge has been applied to the development of multiple diagnostic tests, which are largely based on RNA and miRNA. Common gene probes included in multi-probe tests includePCA3andERG, and the miRNAs miR-21 and miR-141. The next decade will likely bring further improvements in the diagnostic accuracy of biomarkers as well as insights into molecular biological mechanisms of action that can be translated into opportunities in precision uro-oncology.
前列腺癌是英国男性中最常见的非皮肤癌，给社会带来显著的医疗和经济负担。由于前列腺癌存在遗传与临床异质性，且对其潜在生物学机制及疾病发展的自然史认知尚存不确定性，其诊断与风险预测面临挑战。尿液细胞外囊泡是由细胞释放的微观脂双层结构颗粒，携带包括核酸、蛋白质及其他分子在内的多种生物活性物质。尿液是前列腺来源细胞外囊泡的丰富来源。本文通过叙述性综述，系统总结了尿液细胞外囊泡的功能及其在前列腺癌诊断与主动监测领域应用的最新证据。研究表明细胞外囊泡参与前列腺癌所有特征性表现的发展过程，这一认知已被应用于多种诊断检测方法的开发，其中多数基于RNA与miRNA分析。多探针检测中常用的基因探针包括PCA3和ERG，以及miRNA分子miR-21与miR-141。未来十年，生物标志物的诊断准确性有望持续提升，对分子生物学作用机制的深入理解也将为精准泌尿肿瘤学领域创造新的发展机遇。
肿瘤(癌症)患者之家