%0 Journal Article
%T Circulating MicroRNAs as Biomarkers of Prostate Cancer: The State of Play
%A Nikhil Sapre
%A Luke A. Selth
%J Prostate Cancer
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/539680
%X MicroRNAs are key regulators of gene expression and play critical roles in both normal physiology and pathology. Recent research has demonstrated that these molecules are present in body fluids, such as serum, plasma, and urine, and can be readily measured using a variety of techniques. More importantly, emerging evidence suggests that circulating or urine miRNAs are useful indicators of disease. Here, we consider the potential utility of such miRNAs as noninvasive biomarkers of prostate cancer, a disease that would benefit substantially from novel diagnostic and prognostic tools. The studies aimed at identifying diagnostic, prognostic, and/or predictive miRNAs for prostate cancer are summarised and reviewed. Finally, practical considerations that will influence the translation of this recent research into clinical implementation are discussed. 1. The Clinical Problem of Prostate Cancer Prostate cancer is the second most common solid tumour in men worldwide and, despite significant advances in early diagnosis and management, it remains a leading cause of cancer-related death in men [1]. Pathological diagnosis of prostate cancer is usually obtained by a transrectal ultrasound-guided biopsy prompted by elevated levels of serum prostate-specific antigen (PSA) and/or an abnormal digital rectal examination (DRE). The use of PSA for the diagnosis of prostate cancer is associated with several clinical issues. PSA is not specific for this malignancy, being elevated in many other conditions including benign prostatic hyperplasia (BPH), urinary retention, prostatitis, trauma, and physical manipulation [2]. Moreover, elevated levels only correlate loosely with disease severity: approximately 30% of people with PSA 5¨C10 and >50% with PSA > 10 will have prostate cancer [3]. Conversely about 10¨C15% of people with PSA < 5 will harbour prostate cancer [4]. Perhaps more important than its diagnostic inaccuracy, three large clinical trials have revealed that PSA testing/screening is associated with a high rate of overdiagnosis and overtreatment [5¨C7]. Prostate cancer is characterised by distinctly unpredictable outcomes from latent, slow growing tumours to aggressive, rapidly lethal tumours. Although much effort has been put into finding biomarkers that would improve diagnosis, the pertinent clinical issue is the detection of aggressive forms of the disease at an early, curable stage. A significant proportion of cases follow an indolent course and may not require curative treatment. In fact, up to 40% of elderly men will harbour cancer within their prostates at autopsy
%U http://www.hindawi.com/journals/pc/2013/539680/