Department of Pathology, Taizhou People's Hospital, Affiliated to Nanjing University of Traditional Chinese Medicine, Taizhou, Jiangsu, China (mainland).
Department of Rehabilitation, Taizhou People's Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Taizhou, Jiangsu, China (mainland).
Med Sci Monit. 2022 Feb 25;28:e934106. doi: 10.12659/MSM.934106.
Circulating tumor DNA (ctDNA) is a type of cell-free DNA released by tumor cells after necrosis and apoptosis, and it can be actively secreted by tumor cells. Since ctDNA is derived from various tumor sites, it can provide far more comprehensive genomic and epigenomic information than a single-site biopsy. Therefore, ctDNA can overcome tumor heterogeneity, which is the major limitation of a traditional tissue biopsy approach. Noninvasive ctDNA assays allow continuous real-time monitoring of the molecular status of cancers. Recently, ctDNA assays have been widely used in clinical practice, including cancer diagnosis, evaluation of therapeutic efficacy and prognosis, and monitoring of relapse and metastasis. Although ctDNA shows a high diagnostic performance in advanced esophageal cancer, it is far from satisfactory for early diagnosis of esophageal cancer. Monitoring the dynamic changes of ctDNA is beneficial for the evaluation of therapeutic efficacy and prediction of early recurrence in esophageal cancer. It is necessary to establish standards for individualized ctDNA detection in the evaluation of treatment response and surveillance of esophageal cancer and to develop clinical practice guideline for the systemic treatment of patients with "ctDNA recurrence." This review aims to provide an update on the role of ctDNA in the diagnosis and monitoring of esophageal cancer.
循环肿瘤 DNA（ctDNA）是肿瘤细胞坏死和凋亡后释放的一种游离 DNA，它可以被肿瘤细胞主动分泌。由于 ctDNA 来源于各种肿瘤部位，因此它可以提供比单次活检更全面的基因组和表观基因组信息。因此，ctDNA 可以克服肿瘤异质性，这是传统组织活检方法的主要局限性。非侵入性的 ctDNA 检测可实时连续监测癌症的分子状态。最近，ctDNA 检测已广泛应用于临床实践，包括癌症诊断、治疗效果和预后评估以及复发和转移监测。尽管 ctDNA 在晚期食管癌中的诊断性能较高，但用于早期食管癌诊断的效果还远不理想。监测 ctDNA 的动态变化有助于评估治疗效果和预测食管癌的早期复发。有必要建立个体化 ctDNA 检测标准，用于评估治疗反应和监测食管癌，并为“ctDNA 复发”患者的系统治疗制定临床实践指南。本综述旨在提供 ctDNA 在食管癌诊断和监测中的作用的最新信息。
