Openshaw Mark R, McVeigh Terri P
Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom.
Front Digit Health. 2020 Dec 11;2:573010. doi: 10.3389/fdgth.2020.573010. eCollection 2020.
Improving cancer survival rates globally requires improvements in disease detection and monitoring, with the aim of improving early diagnosis and prediction of disease relapse. Traditional means of detecting and monitoring cancers rely largely on imaging and, where possible, blood-based protein biomarkers, many of which are non-specific. Treatments are being improved by identification of inherited and acquired genomic aberrations in tumors, some of which can be targeted by newly developed therapeutic interventions. Treatment of gynecological malignancy is progressively moving toward personalized therapy, as exemplified by application of PARP-inhibition for patients with BRCA-deficient tubo-ovarian cancers, or checkpoint inhibition in patients with mismatch repair-deficient disease. However, the more recent discovery of a group of biomarkers described under the umbrella term of "liquid biopsy" promises significant improvement in our ability to detect and monitor cancers. The term "liquid biopsy" is used to describe an array of tumor-derived material found in blood plasma and other bodily fluids such as ascites, pleural fluid, saliva, and urine. It includes circulating tumors cells (CTCs), circulating nucleic acids including DNA, messenger RNA and micro RNAs, and extracellular vesicles (EVs). In this review, we discuss recent advancements in liquid biopsy for biomarker detection to help in diagnosis, prognosis, and planning of treatment of ovarian and endometrial cancer.
提高全球癌症生存率需要改善疾病检测和监测,目的是改善疾病的早期诊断和复发预测。传统的癌症检测和监测方法很大程度上依赖于成像技术,并在可能的情况下依赖基于血液的蛋白质生物标志物,其中许多是非特异性的。通过识别肿瘤中的遗传和获得性基因组畸变,治疗方法正在得到改进,其中一些畸变可以通过新开发的治疗干预措施进行靶向治疗。妇科恶性肿瘤的治疗正逐渐走向个性化治疗,例如对BRCA缺陷型输卵管卵巢癌患者应用PARP抑制,或对错配修复缺陷疾病患者应用检查点抑制。然而,最近发现的一组被统称为“液体活检”的生物标志物有望显著提高我们检测和监测癌症的能力。“液体活检”一词用于描述在血浆和其他体液(如腹水、胸水、唾液和尿液)中发现的一系列肿瘤衍生物质。它包括循环肿瘤细胞(CTC)、包括DNA、信使RNA和微小RNA在内的循环核酸,以及细胞外囊泡(EV)。在这篇综述中,我们讨论了液体活检在生物标志物检测方面的最新进展,以帮助卵巢癌和子宫内膜癌的诊断、预后和治疗规划。