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Disease prevalence is linked to age, heredity, and race. Prostate cancer genetics has uncovered variants associated with increased risk, yet clinically validated genetic markers are not routinely used. Epigenetic dysregulation—abnormal DNA methylation, chromatin alterations, and miRNA changes—drives tumorigenesis and complements genetic susceptibility. Existing biomarkers like PSA are constrained by sensitivity and specificity, while testing and downstream management costs rise due to false positives and overdiagnosis. Advancing diagnosis and prognosis requires improved risk stratification or better-performing markers, and immunological biomarkers are a promising research direction. The review highlights circulating-monocyte and tumor-associated macrophage (TAM) achievements and their potential to connect genetic predisposition, hormonal metabolism, and immune responses for improved clinical management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prostate-cancer-genetics-epigenetics-and-the-need-for-immunological-biomarkers/379167/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prostate-cancer-genetics-epigenetics-and-the-need-for-immunological-biomarkers/379167.png","ImageObject",300,407,{"name":92,"@type":93},"นรินทร์","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What factors contribute to prostate cancer prevalence and patient burden?","Question",{"text":113,"@type":114},"Prostate cancer prevalence is associated with age, heredity, and race, and it has a high global incidence with substantial impact on patients’ quality of life. Epidemiological estimates also show major mortality worldwide.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why are genetics and epigenetics both important in prostate cancer development?",{"text":118,"@type":114},"Genetic research has identified variants linked to increased risk, but reliable genetic markers are not yet used in clinical practice. Epigenetic changes such as abnormal DNA methylation, chromatin structure alterations, and microRNA (miRNA) expression are described as key drivers of oncogenesis.",{"name":120,"@type":111,"acceptedAnswer":121},"What limitations affect current prostate cancer biomarkers, and what is the proposed solution?",{"text":122,"@type":114},"Markers such as PSA have limitations in sensitivity and specificity. The review notes that improved diagnosis and prognosis may come from narrowing risk groups via new genetic factors or enhancing the sensitivity and specificity of existing markers, including through immunological biomarkers.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},379167,1790631753,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},2336475104957,"https://ap-avatar.wpscdn.com/avatar/22000c4c6bd8a5076e1?x-image-process=image/resize,m_fixed,w_180,h_180&k=1787554080175789136","Review  \nProstate Cancer: Genetics, Epigenetics and the Need for Immunological Biomarkers  \nGuzel Rafikova 1, Irina Gilyazova 1,2, Kadriia Enikeeva 1, Valentin Pavlov 1 and Julia Kzhyshkowska 3,4,5,6, *  \nCitation: Rafikova, G.; Gilyazova, I.; Enikeeva, K.; Pavlov, V.;  \nKzhyshkowska, J. Prostate Cancer: Genetics, Epigenetics and the Need for Immunological Biomarkers. Int. J. Mol. Sci. 2023, 24, 12797. [https://](https://)[ ](https://)[doi.org/10.3390/ijms241612797](doi.org/10.3390/ijms241612797)  \nAcademic Editor: Athanasios  \nG. Papavassiliou  \nReceived: 14 June 2023  \nRevised: 8 August 2023  \nAccepted: 10 August 2023  \nPublished: 14 August 2023  \nCorrection Statement: This article has been republished with a minor change. The change does not affect the scientific content of the article and further details are available within the backmatter of the website version of this article.  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Institute of Urology and Clinical Oncology, Bashkir State Medical University, 450077 Ufa, Russia; [kienikeeva@bashgmu.ru](kienikeeva@bashgmu.ru) (K.E.); [pavlov@bashgmu.ru](pavlov@bashgmu.ru) (V.P.)  \n2 Institute of Biochemistry and Genetics, Ufa Federal Research Center of the Russian Academy of Sciences, 450054 Ufa, Russia  \n3 Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University,  \n634050 Tomsk, Russia  \n4 Genetic Technology Laboratory, Siberian State Medical University, 634050 Tomsk, Russia  \n5 Institute of Transfusion Medicine and Immunology, Mannheim Institute of Innate Immunosciences (MI3), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany  \n6 German Red Cross Blood Service Baden-Württemberg—Hessen, 68167 Mannheim, Germany  \n* Correspondence: julia.kzhyshkowska@medma.uni-heidelberg.de; Tel.: +49-621-383-71716  \nAbstract: Epidemiological data highlight prostate cancer as a significant global health issue, with high incidence and substantial impact on patients’ quality of life. The prevalence of this disease is associated with various factors, including age, heredity, and race. Recent research in prostate cancer genetics has identified several genetic variants that may be associated with an increased risk of developing the disease. However, despite the significance of these findings, genetic markers for prostate cancer are not currently utilized in clinical practice as reliable indicators of the disease. In addition to genetics, epigenetic alterations also play a crucial role in prostate cancer development. Aberrant DNA methylation, changes in chromatin structure, and microRNA (miRNA) expression are major epigenetic events that influence oncogenesis. Existing markers for prostate cancer, such as prostate-specific antigen (PSA), have limitations in terms of sensitivity and specificity. The cost of testing, follow-up procedures, and treatment for false-positive results and overdiagnosis contributes to the overall healthcare expenditure. Improving the effectiveness of prostate cancer diagnosis and prognosis requires either narrowing the risk group by identifying new genetic factors or enhancing the sensitivity and specificity of existing markers. Immunological biomarkers (both circulating and intratumoral), including markers of immune response and immune dysfunction, represent a potentially useful area of research for enhancing the diagnosis and prognosis of prostate cancer. Our review emphasizes the need for developing novel immunological biomarkers to improve the diagnosis, prognosis, and management of prostate cancer. We highlight the most recent achievements in the identification of biomarkers provided by circulating monocytes and","cbCaij7JVJ1S9z4w","https://ap.wps.com/l/cbCaij7JVJ1S9z4w","pdf",1785754,37,"English","# Abstract\n# Epidemiology\n## Global burden of prostate cancer\n## Risk factors and disparities\n# Genetics and epigenetics in prostate cancer\n## Genetic variants and hereditary risk\n## Epigenetic alterations and mechanisms\n# Limitations of existing biomarkers\n## PSA sensitivity and specificity\n## Costs and clinical consequences\n# Immunological biomarkers and research directions\n## Circulating monocytes\n## Tumor-associated macrophages (TAMs)","[{\"question\":\"What factors contribute to prostate cancer prevalence and patient burden?\",\"answer\":\"Prostate cancer prevalence is associated with age, heredity, and race, and it has a high global incidence with substantial impact on patients’ quality of life. Epidemiological estimates also show major mortality worldwide.\"},{\"question\":\"Why are genetics and epigenetics both important in prostate cancer development?\",\"answer\":\"Genetic research has identified variants linked to increased risk, but reliable genetic markers are not yet used in clinical practice. Epigenetic changes such as abnormal DNA methylation, chromatin structure alterations, and microRNA (miRNA) expression are described as key drivers of oncogenesis.\"},{\"question\":\"What limitations affect current prostate cancer biomarkers, and what is the proposed solution?\",\"answer\":\"Markers such as PSA have limitations in sensitivity and specificity. The review notes that improved diagnosis and prognosis may come from narrowing risk groups via new genetic factors or enhancing the sensitivity and specificity of existing markers, including through immunological biomarkers.\"}]","Prostate Cancer: Genetics, Epigenetics and the Need for Immunological Biomarkers | PDF",1790234394,93]