DOI: https://doi.org/10.30841/зм.v0i2(61).116015

Высокомолекулярные белковые биомаркеры рака предстательной железы. Перспективы использования в современной онкоурологии

Р. О. Данилець

Аннотация


Рак предстательной железы (РПЖ) в последние годы заметно распространился среди мужского населения планеты и поэтому на сегодняшний день представляет собой серьезную проблему для здравоохранения многих стран, поскольку по своей летальности среди мужчин с онкологическими заболеваниями РПЖ уступает лишь раку легких. В связи с этим возникла очевидная необходимость в разработке подходов ранней диагностики болезни. Первым общепризнанным биомаркером РПЖ стал протеолитический фермент семейства калликреинов, который получил название калликреин-3 или простатоспецефический антиген (ПСА).
Несмотря на все свои недостатки, а также невысокую чувствительность и специфичность, которые обусловливают появление заметного процента ошибочно-положительных и ошибочно-отрицательных результатов, ПСА-тест уже в течение нескольких десятилетий широко используется в клинической лабораторной диагностике РПЖ. Дальнейшее усовершенствование ПСА-теста осуществлялось путем применения ряда дополнительных биомаркеров, разработанных на основе разных молекулярных форм свободного ПСА в комбинации с комплексным ПСА, среди которых наилучшими прогностическими свойствами, как оказалось, обладает [-2]проПСА. Вследствие этого такие показатели, как % [-2]проПСА и индекс здоровья предстательной железы (ИЗП), который представляет собой математическое произведение % [-2]проПСА на √зПСА, нашли широкое применение в ранней диагностике РПЖ.
В представленном обзоре литературы главным образом обсуждаются высокомолекулярные белковые биомаркеры РПЖ, среди которых наиболее перспективными в качестве альтернативы ПСА предложены следующие: калликреин-2, простатоспецифический мембранный антиген, α-метилацил-КоА-рацемаза, интерлейкин-6, Zn-α2 гликопротеин, EN-2 протеин и β-1 трансформирующий ростовой фактор.
Между тем показано, что с помощью панели биомаркеров, состоящей из урокиназного плазминогенового активатора (уПА), рецептора к уПА и ингибитора уПА типа 1 (уПАИ-1), можно прогнозировать агрессивность опухолей и их склонность к рецидивированию и метастазированию. Это подчеркивает необходимость скорейшего создания доступных эффективных биомаркерных панелей для онкоурологии.


Ключевые слова


биомаркеры; рак предстательной железы; ранняя диагностика; [-2]проПСА, индекс здоровья предстательной железы; высокомолекулярные белки

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Литература


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