文章：

血源性生物分子标志物在前列腺癌发生发展中的作用

Bloodborne biomolecular markers in prostate cancer development and progression

原文发布日期：2002-12-01

DOI: 10.1038/nrc951

类型: Review Article

开放获取: 否

要点：

1. Bloodborne markers for prostate cancer have been known for almost 70 years but many have lacked specificity.
2. The development of the prostate-specific antigen (PSA) blood test as a surrogate marker for disease in the 1980s has revolutionized the diagnosis and management of prostate cancer.
3. Levels of testosterone and other sex hormones provide useful information regarding the effectiveness of hormone therapy, but are not generally helpful for assessing prostate cancer risk or prognosis.
4. Neuroendocrine cells are an integral part of the prostatic epithelium and the degree of neuroendocrine differentiation in prostate tumours seems to correlate with grade and aggressiveness of adenocarcinomas. Specific neuroendocrine markers are detectable in blood and their presence can influence therapeutic decisions.
5. PSA is a secreted serine protease and other members of this class of extracellular protease seem to be important in normal and pathological prostate physiology.
6. Tumour angiogenesis is important in prostate tumour progression and certain angiogenic growth factors, such as vascular endothelial growth factor, have shown prognostic significance in advanced disease.
7. Levels of the growth factor insulin-like growth factor 1 correlate positively with the risk of developing prostate cancer and might prove useful in targeting prevention efforts in men at high risk of disease.
8. Bone metabolites, particularly breakdown products of collagen, can reflect changes in bony lesions, which are a prominent component of metastatic prostate cancer.
9. New proteomic technologies allow the simultaneous analysis of several bloodborne factors from small samples. These hold promise for more selective serological fingerprinting of prostate cancer patients for both diagnostic and prognostic purposes.

要点翻译：

1. 前列腺癌的血液生物标志物已被发现近70年，但多数标志物缺乏特异性。
2. 20世纪80年代前列腺特异性抗原（PSA）血液检测作为疾病替代标志物的开发，彻底改变了前列腺癌的诊断和治疗管理。  
3. 睾酮和其他性激素水平可反映激素治疗的有效性，但通常对评估前列腺癌风险或预后无显著帮助。  
4. 神经内分泌细胞是前列腺上皮的组成部分，前列腺肿瘤中神经内分泌分化程度似乎与腺癌的分级和侵袭性相关。特异性神经内分泌标志物可在血液中检测到，其存在可能影响治疗决策。  
5. PSA是一种分泌型丝氨酸蛋白酶，该细胞外蛋白酶家族的其他成员在正常及病理性前列腺生理过程中具有重要作用。  
6. 肿瘤血管生成在前列腺肿瘤进展中至关重要，某些血管生成生长因子（如血管内皮生长因子）在晚期疾病中显示出预后意义。  
7. 生长因子胰岛素样生长因子1的水平与前列腺癌发病风险呈正相关，或可用于针对高风险人群的预防干预。  
8. 骨代谢物（尤其是胶原蛋白分解产物）可反映骨骼病变的变化，而骨转移是转移性前列腺癌的主要组成部分。  
9. 新型蛋白质组学技术允许对微量样本中的多种血液因子进行同步分析，这为通过更精准的血清学指纹图谱技术实现前列腺癌诊断和预后评估提供了新前景。

英文摘要：

Prostate cancer is notoriously difficult to treat, which makes its early detection a priority. Biomarkers have been used to diagnose and monitor prostate cancer for more than 50 years, and the discovery of the serum marker prostate-specific antigen (PSA) significantly altered the detection and management of prostate cancer. But imperfect correlation with cancer hinders the usefulness of PSA. The elucidation and validation of new biological markers of prostate cancer should aid detection, and improve the application of the available therapeutics.

摘要翻译： 

前列腺癌素以难治著称，因此其早期发现至关重要。生物标志物用于前列腺癌的诊断与监测已有五十余年，血清标志物前列腺特异性抗原（PSA）的发现显著改变了前列腺癌的检测与管理。然而，PSA 与癌症的相关性并不完美，限制了其临床应用价值。阐明并验证新的前列腺癌生物标志物，将有助于提高检测水平，并优化现有治疗手段的应用。

原文链接：

Bloodborne biomolecular markers in prostate cancer development and progression