Development of Protein Biomarkers in Post-DRE Urine for use in Liquid Biopsy of Prostate Cancer

前列腺癌是一个主要的和日益严重的健康问题。前列腺癌是区别于几乎所有其他成年人 癌症具有显著的临床异质性虽然有些癌症类型几乎是普遍可治愈的（如甲状腺癌）， 癌症），并且其他几乎普遍致命（例如胰腺癌），前列腺癌的特征在于它们的 可变性前列腺特异性抗原（PSA）是用来筛查前列腺癌的，而PSA筛查的引入 检测到的低风险癌症比“PSA前”时代更多。大约40%的新诊断的前列腺癌是 懒惰，不会在人的一生中造成重大的健康问题。然而，其余的范围从 中到高风险，尽管有明确的局部治疗，约10-20%的患者最终会进展到更多 侵袭性疾病因此，前列腺癌的关键临床问题不是疾病的早期发现，而是早期诊断。 检测侵袭性疾病。非裔美国人（AA）男性前列腺癌的发病率明显较高 总体而言，沿着确定性局部治疗后复发率和疾病特异性死亡率的升高。AA男人 低风险疾病谁选择手术几乎有两倍的升级率，并增加了不良反应的频率， 病理学这些发现导致不愿意招募AA男性进行主动监测，因为担心 存在侵袭性疾病。同样清楚的是，目前基于组织的前列腺癌生物标志物表现不同 在AA男性相对于欧洲男性（EA）。例如，PTEN缺失和ERG表达较不常见， AA男性前列腺肿瘤的发病率普遍的共识是，使用适当的生物标志物， 可以调整管理战略，以实现祖传的公平。我们假设非侵入性生物标记物 在高加索血统男性中开发的生物标记物在AA血统男性中不会同样有效， 发展策略将改善AA患者的预后

Prostate cancer is a major and growing health problem. Prostate cancer is distinguished from almost every other adult cancer by its remarkable clinical heterogeneity. While some cancer types are almost universally curable (e.g. thyroid cancer), and others are almost universally lethal (e.g. pancreatic cancer), prostate cancers are characterized by their variability. Prostate specific antigen (PSA) is used to screen for prostate cancer, and the introduction of PSA screening detected more low risk cancers than in the “pre-PSA” era. About 40% of newly diagnosed prostate cancers are indolent and will not cause significant health problems during a man’s life. However, the remainder range from intermediate to high risk, and despite definitive local therapy about 10-20% will end up progressing to more aggressive disease. Thus, the key clinical problem in prostate cancer is not early detection of disease, but rather early detection of aggressive disease. African American (AA) men have a significantly higher incidence of prostate cancer overall, along with elevated rates of relapse after definitive local therapy and disease-specific mortality. AA men with low-risk disease who opt for surgery have almost twice the rate of upgrading, and increased frequency of adverse pathologies. These findings have led to a reluctance to recruit AA men onto active surveillance due to concern for presence of aggressive disease. It is also clear that current tissue-based prostate cancer biomarkers perform differently in AA men relative to men of European Ancestry (EA). For example, PTEN loss and ERG expression is less frequent in prostate tumors arising in AA men. It is a general consensus that with the appropriate biomarkers current clinical management strategies can be tailored to achieve ancestral equity. We hypothesize that non-invasive biomarkers developed in men of Caucasian ancestry will not be equally effective in men of AA ancestry and dedicated biomarker development strategies will improve prognosis of AA patients