Although prostate-specific antigen-based prostate cancer screening had a positive impact in reducing prostate cancer mortality, it also led to overdiagnosis, overtreatment and a significant number of unnecessary biopsies. In the post-prostate-specific antigen era, new biomarkers have emerged that can complement the information given by prostate-specific antigen, towards a better cancer diagnostic specificity, and also allowing a better estimate of the aggressiveness of the disease and its clinical outcome. That means those markers have the potential to assist the clinician in the decision-making processes, such as whether or not to perform a biopsy, and to make the best treatment choice among the new therapeutic options available, including active surveillance in lower risk disease. In this article, we will review several of those more recent diagnostic markers (4Kscore®, [-2]proPSA and Prostate Health Index, SelectMDx®, ConfirmMDx®, Progensa® Prostate Cancer Antigen 3, Mi-Prostate Score, ExoDx™ Prostate Test, the Stockholm3 test and ERSPC risk calculators) and prognostic markers (OncotypeDX® Genomic Prostate Score, Prolaris®, Decipher® and ProMark®). We will also address some new liquid biopsy approaches – circulating tumour cells and cell-free DNA – with a potential role in metastatic castration-resistant prostate cancer and will briefly give some future perspectives, mostly outlooking epigenetic markers.

尽管基于前列腺特异性抗原的前列腺癌筛查对降低前列腺癌死亡率有积极影响，但它也导致过度诊断、过度治疗和大量不必要的活检。在后前列腺特异性抗原时代，出现了新的生物标志物，可以补充前列腺特异性抗原所提供的信息，以获得更好的癌症诊断特异性，也可以更好地估计疾病的侵袭性及其临床结果。这意味着这些标志物有可能在决策过程中帮助临床医生，例如是否进行活检，并在可用的新治疗方案中做出最佳治疗选择，包括对低风险疾病的主动监测。在本文中，我们将回顾一些较新的诊断标志物（4Kscore®、[-2]proPSA 和前列腺健康指数、SelectMDx®、ConfirmMDx®、Progensa® 前列腺癌抗原 3、Mi-Prostate 评分、ExoDx™ 前列腺测试、Stockholm3 测试和 ERSPC 风险计算器）和预后标志物（OncotypeDX® 基因组前列腺评分、Prolaris®、Decipher® 和 ProMark®）。我们还将讨论一些新的液体活检方法——循环肿瘤细胞和游离 DNA——在转移性去势抵抗性前列腺癌中具有潜在作用，并将简要介绍一些未来的观点，主要是展望表观遗传标记。Stockholm3 测试和 ERSPC 风险计算器）和预后标志物（OncotypeDX® 基因组前列腺评分、Prolaris®、Decipher® 和 ProMark®）。我们还将讨论一些新的液体活检方法——循环肿瘤细胞和游离 DNA——在转移性去势抵抗性前列腺癌中具有潜在作用，并将简要介绍一些未来的观点，主要是展望表观遗传标记。Stockholm3 测试和 ERSPC 风险计算器）和预后标志物（OncotypeDX® 基因组前列腺评分、Prolaris®、Decipher® 和 ProMark®）。我们还将讨论一些新的液体活检方法——循环肿瘤细胞和游离 DNA——在转移性去势抵抗性前列腺癌中具有潜在作用，并将简要介绍一些未来的观点，主要是展望表观遗传标记。