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Bioprocess 2025
神经内分泌前列腺癌的研究进展
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Abstract:
神经内分泌前列腺癌(Neuroendocrine Prostate Cancer, NEPC)是前列腺癌中一类具有高度侵袭性且致死率极高的特殊亚型，其临床特征主要表现为疾病进展迅速、对常规雄激素受体(Androgen Receptor, AR)靶向治疗存在原发性耐药或继发性耐药，且患者预后极差。尽管少数情况下NEPC可原发发生，但更多病例源自前列腺癌在长期接受雄激素剥夺治疗(Androgen Deprivation Therapy, ADT)或雄激素受体通路抑制剂(Androgen Receptor Pathway Inhibitor, ARPI)治疗的压力下，发生转分化而形成。然而，该转分化机制的分子基础迄今仍存在较大争议。NEPC患者整体生存率极低，且目前有效的治疗手段十分有限，其临床管理面临重大挑战。本文系统综述了NEPC的最新研究进展，旨在为NEPC的基础研究转化与临床治疗优化提供参考。
Neuroendocrine Prostate Cancer (NEPC) is a rare but highly aggressive subtype of prostate cancer with an exceptionally high mortality rate. Clinically, NEPC is characterized by rapid disease progression, primary resistance or acquired resistance to conventional Androgen Receptor (AR)—targeted therapies, and extremely poor prognosis. Although NEPC can arise de novo in a minority of cases, it more commonly develops through transdifferentiation of prostate adenocarcinoma under the selective pressure of long-term Androgen Deprivation Therapy (ADT) or Androgen Receptor Pathway Inhibitor (ARPI). However, the molecular mechanisms underlying this transdifferentiation remain highly controversial. NEPC patients exhibit very low overall survival, and effective therapeutic options are currently limited, posing major challenges to clinical management. This review provides a comprehensive overview of recent advances in NEPC research, aiming to inform future translational studies and the optimization of clinical treatment strategies.
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