Following the introduction of routine Prostate Specific Antigen (PSA) screening in the early 1990′s, Prostate Cancer (PCa) is often detected at an early stage. There are also a growing number of treatment options available and so the associated mortality rate is generally low. However, PCa is an extremely complex and heterogenous disease and many patients suffer disease recurrence following initial therapy. Disease recurrence commonly results in metastasis and metastatic PCa has an average survival rate of just 3–5 years. A significant problem in the clinical management of PCa is being able to differentiate between patients who will respond to standard therapies and those who may benefit from more aggressive intervention at an earlier stage. It is also acknowledged that for many men the disease is not life threatenting. Hence, there is a growing desire to identify patients who can be spared the significant side effects associated with PCa treatment until such time (if ever) their disease progresses to the point where treatment is required. To these important clinical needs, current biomarkers and clinical methods for patient stratification and personlised treatment are insufficient. This review provides a comprehensive overview of the complexities of PCa pathology and disease management. In this context it is possible to review current biomarkers and proteomic technologies that will support development of biomarker-driven decision tools to meet current important clinical needs. With such an in-depth understanding of disease pathology, the development of novel clinical biomarkers can proceed in an efficient and effective manner, such that they have a better chance of improving patient outcomes.

中文翻译：

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前列腺癌的临床蛋白质组学：了解前列腺癌的病理学和蛋白质生物标记物以改善疾病管理

在1990年代初期引入常规前列腺特异性抗原（PSA）筛查后，经常在早期发现前列腺癌（PCa）。可用的治疗选择也越来越多，因此相关的死亡率通常很低。但是，PCa是一种极其复杂且异质的疾病，许多患者在接受初始治疗后会复发疾病。疾病复发通常导致转移，转移性PCa的平均生存率仅为3-5年。PCa临床管理中的一个重要问题是，如何区分对标准疗法有反应的患者和可能在早期接受更积极干预的患者。还公认的是，对于许多男人而言，该疾病不会威胁生命。因此，人们越来越需要确定可以避免与PCa治疗相关的重大副作用的患者，直到他们的疾病进展到需要治疗的程度为止（如果有的话）。对于这些重要的临床需求，当前用于患者分层和个性化治疗的生物标志物和临床方法还不够。这篇综述全面概述了PCa病理学和疾病管理的复杂性。在这种情况下，有可能审查当前的生物标志物和蛋白质组学技术，这些技术将支持生物标志物驱动的决策工具的开发，以满足当前重要的临床需求。通过对疾病病理学的深入了解，新型临床生物标记物的开发可以有效而有效地进行，