Introduction

This manuscript aims to give an overview of current diagnostic, staging, and prognostic markers for prostate cancer (PCa) and discuss emerging approaches. The widespread use of PSA for early detection led to improved survival but at the cost of over-diagnosis, often associated with over-treatment and its adverse events. There is thus an unmet need for new markers to sustainably improve the diagnosis and risk assessment, thereby providing a more accurate treatment decision for each individual patient.

Areas covered

Promising new molecular serum (PSA, PHI, 4Kscore®), urine (Progensa®, SelectMDx®, MiPS) and tissue-based markers (Ki-67, Prolaris®, ConfirmMDx®, Oncotype Dx®, Decipher®, Promark®) will be discussed in this review.

Expert opinion

Over-diagnosis and difficulties in prognosticating clinical outcome among patients with similar histological and clinical parameters often lead to over- or under-treatment.

New markers will probably be used with clinical and histopathological features as well as imaging diagnostics to capture the comprehensive biology and clinical behavior of PCa.

New biomarkers open the avenue to avoid mpMRI with targeted biopsy in the future, thereby sparing risks and pitfalls associated with this approach.

Before this utopia becomes reality, the panel of technologically complementary markers need to prove that they are better, cheaper, and faster than current strategies.

中文翻译：

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当前和新兴的前列腺癌诊断、分期和预后标志物的概述。

介绍

这份手稿旨在概述当前前列腺癌 (PCa) 的诊断、分期和预后标志物，并讨论新兴方法。PSA 用于早期检测的广泛使用提高了生存率，但以过度诊断为代价，通常与过度治疗及其不良事件有关。因此，对新标志物的需求未得到满足，以可持续地改进诊断和风险评估，从而为每个患者提供更准确的治疗决策。

覆盖区域

有前景的新分子血清（PSA、PHI、4Kscore®）、尿液（Progensa®、SelectMDx®、MiPS）和基于组织的标记物（Ki-67、Prolaris®、ConfirmMDx®、Oncotype Dx®、Decipher®、Promark®）将将在本次审查中讨论。

专家意见

在具有相似组织学和临床参数的患者中，过度诊断和难以预测临床结果通常会导致过度治疗或治疗不足。

新标记可能会与临床和组织病理学特征以及成像诊断一起使用，以捕获 PCa 的综合生物学和临床行为。

新的生物标志物为未来避免 mpMRI 和靶向活检开辟了道路，从而避免了与这种方法相关的风险和陷阱。

在这个乌托邦成为现实之前，技术互补的标记小组需要证明它们比当前的策略更好、更便宜、更快。