前列腺癌 z-bo 2020-12-18 313

　　The genetic pathways of cancer cells indicate that the patient’s tumor disease may develop into an aggressive disease. Scientists at the Sidders-Sinai Medical Center in the United States have developed a new method to determine which patients have prostate cancer that is likely to develop into an aggressive cancer, even if their tumors are at a lower risk when first discovered. Sex. This new research result helps doctors implement the most effective treatment measures for each patient based on understanding how individual tumor genes are activated. Sungyong You, MD, an instructor in the Surgical Ward of the Sidders-Sinai Medical Center in the United States, and the first author of the study, said: "By determining the gene expression profile of tumor patients, these studies have found to improve This allows doctors to recognize the possibility of aggressive diseases in the early diagnosis and early treatment."

　　 Prior to this, other studies have used genetic data to identify various subtypes of prostate cancer. This is the first large-scale study to link clinical results to prostate cancer subtypes based on the activation and shutdown of genes in cancer cells. The results of the study were published in Cancer Research of the American Association for Cancer Research.

　　According to a study by the American Cancer Society, 1 in 7 men has prostate cancer, which is the second leading cause of cancer death in American men. Most tumors grow slowly and have no life-threatening risk, but certain types of prostate cancer can spread to other organs and are fatal.

　　 Based on the gene activation pathway of each tumor, new research results divide prostate tumors into three subtypes. When the researchers matched these data with the clinical results of more than 4,600 patients in the medical database, they found that these subtypes were associated with different levels of disease progression.

　　 The conclusion of this study solves a major problem in the current standard of prostate cancer treatment: because the basic biology of the tumor is not known, doctors cannot reliably predict which patient's tumor will develop into a fatal cancer subtype. "About 60% of the prostate cancer patients we treat will not progress to aggressive cancer. The key problem is that we have no way of knowing which patients will be one of those 60%." said Michael Freeman, MD, who is this The lead researcher of the study and the director of cancer biology at the Sidders-Sinai Medical Center in the United States is mainly engaged in therapeutic research in the Department of Biomedical Sciences at the Sidders-Sinai Medical Center. "We hope that our research results will help doctors provide more patients with the best treatment options and produce healthier results."

　　 This new study may lead to changes in treatment decisions for prostate cancer patients. At present, doctors mainly rely on Gleason grading to develop prostate cancer treatment plans. For tumors found by surgical biopsy, the degree of differentiation of tumor cells is divided according to the similarity between cancer cells and normal prostate cells, and points are scored from 2 to 10 points, and tumors are graded according to Gleason classification. The lower the grade, the lower the risk of cancer.

　　 However, a study by the U.S. Sidders-Sinai Medical Center has shown that some prostate cancer patients cannot get the treatment they need in time. Others may receive unnecessary treatment and have significant side effects. Common treatments for prostate cancer are radiation therapy, hormone therapy and surgical removal of the prostate.

　　 At present, patients with low-grade prostate cancer often do not receive treatment, and require close observation of their condition under a strategy called active surveillance. At the same time, new research shows that some active monitoring of these patients may not be enough.

　　Research shows that among the three types of prostate cancer, a subtype called PCS1 by researchers is generally aggressive. In the patients they studied, this subtype can easily metastasize and develop into poor clinical results, and even death, even if the Gleason grade of this subtype is very low. The other two subtypes PCS2 and PCS3 progress relatively slowly.

　　 Another advantage of this new classification strategy is that tumor cells circulating in the blood can be used for tumor classification. Sungyong You believes that this discovery is expected to strengthen researchers' real-time monitoring of tumor development during treatment.