Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia.
Clinic for Digestive Surgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Surg Oncol. 2022 May;41:101743. doi: 10.1016/j.suronc.2022.101743. Epub 2022 Mar 24.
The progress that has been made in the treatment of rectal cancer has mostly resulted from multimodality strategy approach that combines surgery, chemotherapy and radiotherapy. In locally advanced rectal cancer (LARC), surgery remains the primary treatment, while neoadjuvant chemoradiotherapy (nCRT) is used to downsize or downstage the tumor before surgical resection. Highly variable response to nCRT observed in LARC patients raises the need for biomarkers to enable prediction and evaluation of treatment response in a more efficient and timely manner than currently available tools. The search for predictive biomarkers continues beyond blood proteins, which have failed in subsequent validation studies. This review presents nucleic acids-based markers and their predictive potential in LARC patients. Most of the candidate biomarkers come from relatively small single-institution studies. The only candidate biomarker that emerged as relevant in more than a single study was elevated levels of Fusobacterium nucleatum nucleic acids in tumor tissue. Considering that this marker is easily accessible through non-invasive analysis of faecal samples, its predictive potential is worth further validation. The other candidate nucleic acid-based biomarkers require more consistent studies on larger cohorts before they can be considered for use in clinical setting.
直肠癌治疗的进展主要源于多模式策略，该策略结合了手术、化疗和放疗。在局部进展期直肠癌（LARC）中，手术仍然是主要治疗方法，而新辅助放化疗（nCRT）用于在手术切除前缩小或降期肿瘤。LARC 患者对 nCRT 的反应存在高度变异性，这就需要生物标志物来实现比现有工具更高效和及时的治疗反应预测和评估。对血液蛋白以外的预测生物标志物的研究仍在继续，但这些标志物在后续验证研究中均未成功。本文综述了基于核酸的标志物及其在 LARC 患者中的预测潜力。大多数候选生物标志物来自相对较小的单机构研究。唯一在多个研究中均显示出相关性的候选生物标志物是肿瘤组织中高水平的具核梭杆菌核酸。鉴于该标志物可通过粪便样本的非侵入性分析轻松获得，其预测潜力值得进一步验证。其他候选的基于核酸的生物标志物需要在更大的队列中进行更一致的研究，才能考虑将其用于临床。
