Tsujiura Masahiro, Ichikawa Daisuke, Konishi Hirotaka, Komatsu Shuhei, Shiozaki Atsushi, Otsuji Eigo
Masahiro Tsujiura, Daisuke Ichikawa, Hirotaka Konishi, Shuhei Komatsu, Atsushi Shiozaki, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
World J Gastroenterol. 2014 Mar 28;20(12):3265-86. doi: 10.3748/wjg.v20.i12.3265.
To improve the clinical outcomes of cancer patients, early detection and accurate monitoring of diseases are necessary. Numerous genetic and epigenetic alterations contribute to oncogenesis and cancer progression, and analyses of these changes have been increasingly utilized for diagnostic, prognostic and therapeutic purposes in malignant diseases including gastric cancer (GC). Surgical and/or biopsy specimens are generally used to understand the tumor-associated alterations; however, those approaches cannot always be performed because of their invasive characteristics and may fail to reflect current tumor dynamics and drug sensitivities, which may change during the therapeutic process. Therefore, the importance of developing a non-invasive biomarker with the ability to monitor real-time tumor dynamics should be emphasized. This concept, so called "liquid biopsy", would provide an ideal therapeutic strategy for an individual cancer patient and would facilitate the development of "tailor-made" cancer management programs. In the blood of cancer patients, the presence and potent utilities of circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) such as DNA, mRNA and microRNA have been recognized, and their clinical relevance is attracting considerable attention. In this review, we discuss recent developments in this research field as well as the relevance and future perspectives of CTCs and cfNAs in cancer patients, especially focusing on GC.
为改善癌症患者的临床结局，疾病的早期检测和准确监测必不可少。众多基因和表观遗传改变促成肿瘤发生和癌症进展，对这些变化的分析已越来越多地用于包括胃癌（GC）在内的恶性疾病的诊断、预后评估和治疗。手术和/或活检标本通常用于了解肿瘤相关改变；然而，由于这些方法具有侵入性，并非总能实施，且可能无法反映当前的肿瘤动态和药物敏感性，而这些在治疗过程中可能会发生变化。因此，应强调开发一种能够监测实时肿瘤动态的非侵入性生物标志物的重要性。这一概念，即所谓的“液体活检”，将为个体癌症患者提供理想的治疗策略，并有助于制定“量身定制”的癌症管理方案。在癌症患者的血液中，循环肿瘤细胞（CTC）和游离核酸（cfNA）如DNA、mRNA和微小RNA的存在及其强大作用已得到认可，它们的临床相关性正引起广泛关注。在本综述中，我们讨论了该研究领域的最新进展以及癌症患者中CTC和cfNA的相关性及未来前景，尤其聚焦于胃癌。
