前列腺癌筛查研究现状

Current status of prostate cancer screening research

摘要

前列腺癌是全球男性发病率第二位的恶性肿瘤，其早期诊断依赖筛查。如何提高临床有意义前列腺癌的检出率，避免低危肿瘤的过度诊断与过度治疗，同时兼顾经济效益比，已成为前列腺癌筛查领域的核心问题。当前国际前列腺癌筛查策略正从单一的前列腺特异性抗原（prostate specific antigen，PSA）筛查走向个体化风险分层，并探索整合磁共振成像（magnetic resonance imaging，MRI）、新型生物标志物及风险预测模型等多种分层工具的作用，但尚无公认的统一路径。近年来，我国前列腺癌发病率虽快速上升，但早期诊断率仍较低，这与我国前列腺癌筛查普及率不足直接相关，而且我国还面临老年高危人群的合理筛查模式缺乏、公众认知不足、精细化筛查路径缺失等问题。未来需要基于中国人群数据，构建适合中国国情的分层筛查策略，以推动筛查从机会性向系统性转变。

Abstract

Prostate cancer is the second most common malignant tumor among men worldwide.Its early diagnosis relies on screening.How to increase the detection rate of clinically significant prostate cancer， avoid overdiagnosis and over-treatment of low-risk tumors，while also considering economic benefits，has become a core issue in the field of screening.Currently，international prostate cancer screening strategies are moving from a single prostate-specific antigen（PSA）screening to individualized risk stratification，and exploring the roles of various stratification tools，such as magnetic resonance imaging（MRI），new biomar-kers，and risk prediction models.However，there is no universally recognized unified approach.In recent years，although the incidence of prostate cancer in China has increased rapidly，the early diagnosis rate is still low.This is directly related to the insufficient prevalence of prostate cancer screening in China.More-over，China also faces problems such as the lack of a reasonable screening model for elderly high-risk populations，insufficient public awareness，and the absence of a refined screening path.Future work involves building stratified screening strategies suitable for the Chinese population based on Chinese data， promoting the transition of screening from opportunistic to systematic，and is a task that needs to be carried out.

关键词

前列腺肿瘤 / 癌症早期检测 / 社区卫生服务 / 多参数磁共振成像

Key words

Prostate tumor / Early cancer detection / Community health service / Multiparametric nuclear magnetic resonance

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