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前列腺癌是泌尿系统最常见的恶性肿瘤之一,居男性肿瘤特异性死亡率的第二位,且呈逐年上升趋势。相当一部分患者确诊时已失去手术治疗的最佳机会,这部分患者虽对内分泌治疗(去雄)有初效,但最终可发展为去势抵抗性前列腺癌(castration resistant prostate cancer,CRPC)。该类患者预后差,对治疗反应差异性大,中位生存时间数1~2年,且对治疗预后的评判也难以量化明确。近年来,循环肿瘤细胞(CTCs)检测计数,甲基化表型分析及标记物检测等研究对于肿瘤细胞迁移,预后评估,个体化治疗显现出重要意义。因此,作者就CTCs的总体概况及目前在前列腺癌中的临床应用进行总结,为CRPC的个体化治疗方向提供参考。
Prostate cancer is one of the most common malignant tumors in the urinary system, ranking the second among men with specific tumor-specific mortality rate. A considerable number of patients have the best chance of losing their surgical treatment at the time of diagnosis. Although these patients may have initial effect on endocrine therapy, they may eventually develop castration resistant prostate cancer (CRPC). Such patients with poor prognosis, the response to the treatment of large differences, the median survival time of 1 to 2 years, and the prognosis of the treatment is difficult to quantify the quantitative evaluation. In recent years, the research on counting of circulating tumor cells (CTCs), methylation phenotype analysis and marker detection has shown great significance for tumor cell migration, prognosis evaluation and individualized treatment. Therefore, the author summarizes the general situation of CTCs and the current clinical application in prostate cancer, providing a reference for the individualized treatment of CRPC.