[Hormonal and molecular biological factors in pathogenesis of prostate cancer]

Moleculo-genetic pathways of development and progression of prostate cancer have been studied. In the norm, paracrine regulation of the glandular secretory epithelium are predominant due to the influence of hormonal and protein factors of the stroma. The altered prostatic epithelium becomes independent from the stroma and androgens and, consequently, prone to metastasizing, following activation of protooncogenes (growth factor genes), inactivation of gene-suppressors, hyperexpression of certain growth factors and apoptosis inhibitor Bcl-2, and inactivation of androgen receptor. In inoperable prostate cancer, palliative treatment should include antiandrogen therapy, inhibition of growth factors and activation of apoptosis. Prevention and medication for prostate cancer targeting apoptosis, growth factors and androgens should be based on recent achievements in experimental genotherapy and selective use of proliferation inhibitors and apoptosis activators which are to be fed to the gland via viral and non-viral vectors. Molecular-biological markers of risk for cancer, its early detection, prognosis of clinical course and effectiveness of treatment are discussed. A modality for laboratory diagnosis and complex treatment of prostate cancer offering maximum survival so far has been suggested.