Prostate cancer is one of the most common malignant tumors in men and posing a serious threat to men's health. Detection methods such as prostate-specific antigen (PSA), prostate biopsy, and magnetic resonance imaging are widely used for prostate cancer screening, but they have low specificity, high cost, and significant risks. Therefore, there is an urgent need to develop highly specific, low-cost, easily obtained, stable, and reliable biomarkers, and use them as the basis to establish non-invasive screening and diagnostic methods for prostate cancer. This paper reviewed the recent advances in the use of prostate cancer biomarkers and combined detection methods for prostate cancer diagnosis and prognosis assessment and provides an in-depth analysis and comparison of different biomarkers and combined detection methods, as well as points out the directions and challenges for future research. The paper emphasizes the importance of developing efficient, cost-effective and easy-to-implement biomarkers to increase the early diagnosis rate of prostate cancer, improve patient prognosis, and reduce the waste of healthcare resources. This paper provides an important theoretical basis and technical guidance for early diagnosis, precise treatment and prognostic evaluation of prostate cancer, and has important reference value for promoting clinical research and practice of prostate cancer.
Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Biomarkers, Tumor/blood* ; Early Detection of Cancer/methods* ; Prognosis ; Prostate-Specific Antigen/blood* ; Glutamate Carboxypeptidase II/metabolism* ; Antigens, Neoplasm/blood* ; Antigens, Surface ; Serine Endopeptidases

Objective: To evaluate the feasibility of expanded indication for endoscopic submucosal dissection (ESD) in undifferentiated early gastric cancer, to investigate the risk factors of lymph node metastasis (LNM), so as to provide the theoretical evidence for the choice of treatment. Methods: From June 2007 to December 2018, at the Affiliated Hospital of Qingdao University, the clinical and pathological data of 807 patients with undifferentiated early gastric cancer and undergoing gastrectomy plus lymphadenectomy were retrospectively analyzed. Chi-square test was performed to analyze the correlation between clinicopathologic characteristics of early gastric cancer and LNM. Multivariate logistic regression model was used to analyze the independent risk factor of LNM. Results: LNM was found in 17.2% (139/807) patients with undifferentiated early gastric cancer. And no LNM was detected in 110 patients who met the expanded indication of ESD. The results of univariate analysis indicated that LNM was significantly associated with increased carcinoembryonic antigen (CEA), tumour size, gross type, ulcer, invasion depth, lymphovascular invasion and perineural invasion (χ²=4.500, 13.332, 16.611, 6.083, 51.064, 0.564 and 17.006, all P<0.05). The results of multivariate analysis demonstrated that the maximum diameter of tumor over 20 mm (odds ratio (OR)=1.606, 95% confidence interval (CI) 1.021 to 2.526, P=0.040), lymphovascular invasion (OR=16.835, 95%CI 10.510 to 26.966, P<0.01), the depth of submucosal superficial invasion (≤500 μm ; OR=1.962, 95%CI 1.022 to 3.765, P=0.043) and the depth of submucosal deep invasion (>500 μm ; OR=3.014, 95%CI 1.753 to 5.181, P<0.01) were independent risk factors of LNM in early gastric cancer. Conclusions The expanded ESD indication of undifferentiated early gastric cancer is applicable for endoscopic treatment considering the low risk of LNM. In early undifferentiated gastric cancer, maximum diameter of tumor over 20 mm, lymphovascular invasion, submucosal superficial and deep invasion are the independent risk factors of LNM.