Poggiana Cristina, Rossi Elisabetta, Zamarchi Rita
Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
J Thorac Dis. 2020 Jul;12(7):3821-3835. doi: 10.21037/jtd.2020.02.24.
The prognosis of lung cancer varies highly depending on the disease stage at diagnosis, from a 5-year survival rate close to 90% in stage I, to 10% or less in stage IV disease. The enhancement of early diagnosis of this malignancy is mandatory to improve prognosis, because lung cancer patients stay long asymptomatic or few symptomatic after disease onset. Nowadays, liquid biopsy has emerged as a minimally-invasive tool to address the urgent need for real time monitoring, stratification, and personalized treatment of malignancies, including lung cancer. Liquid biopsy refers to a class of biomarkers, including circulating tumor cells (CTCs), cell-free circulating tumor DNA (ctDNA) and tumor-derived extracellular vesicles (tdEV). Since CTCs represent a crucial step in disease progression and metastasis, we reviewed here the scientific literature about the use of CTCs in early diagnosis of lung cancer; different techniques, and different strategies (e.g., source of analysis sample or high-risk groups of patients) were discussed showing the potential of implementing liquid biopsy in the clinical routine of non-metastatic lung cancer.
肺癌的预后因诊断时的疾病阶段不同而有很大差异，从I期接近90%的5年生存率到IV期疾病的10%或更低。由于肺癌患者在疾病发作后很长时间没有症状或症状很少，因此加强这种恶性肿瘤的早期诊断对于改善预后至关重要。如今，液体活检已成为一种微创工具，以满足对包括肺癌在内的恶性肿瘤进行实时监测、分层和个性化治疗的迫切需求。液体活检是指一类生物标志物，包括循环肿瘤细胞（CTC）、游离循环肿瘤DNA（ctDNA）和肿瘤来源的细胞外囊泡（tdEV）。由于循环肿瘤细胞是疾病进展和转移的关键步骤，我们在此回顾了关于循环肿瘤细胞在肺癌早期诊断中应用的科学文献；讨论了不同的技术和不同的策略（例如，分析样本来源或高危患者群体），展示了在非转移性肺癌临床常规中实施液体活检的潜力。
