Department of Neurosurgery, Penn State Hershey College of Medicne, Hershey, Pennsylvania, USA.
Department of Neurosurgery, Penn State Hershey College of Medicne, Hershey, Pennsylvania, USA.
World Neurosurg. 2023 Feb;170:182-194. doi: 10.1016/j.wneu.2022.11.012. Epub 2022 Nov 5.
There is a pressing clinical need for minimally invasive liquid biopsies to supplement imaging in the treatment of glioblastoma. Diagnostic imaging is often difficult to interpret and the medical community is divided on distinguishing among complete response, partial response, stable disease, and progressive disease. A minimally invasive liquid biopsy would supplement imaging and clinical findings and has the capacity to be helpful in several ways: 1) diagnosis, 2) selection of patients for specific treatments, 3) tracking of treatment response, and 4) prognostic value. The liquid biome is the combination of biological fluids including blood, urine, and cerebrospinal fluid that contain small amounts of tumor cells, DNA/RNA coding material, peptides, and metabolites. Within the liquid biome, 2 broad categories of biomarkers can exist: tumor-derived, which can be directly traced to the tumor, and tumor-associated, which can be traced back to the response of the body to disease. Although tumor-associated biomarkers are promising liquid biopsy candidates, recent advances in biomarker enrichment and detection have allowed concentration on a new class of biomarker: tumor-derived biomarkers. This review focuses on making the distinction between the 2 biomarker categories and highlights promising new direction.
临床上迫切需要微创液体活检来补充成像技术，以辅助胶质母细胞瘤的治疗。诊断成像往往难以解读，医学界在区分完全缓解、部分缓解、稳定疾病和进展性疾病方面存在分歧。微创液体活检可以补充成像和临床发现，并具有以下几个方面的辅助作用：1）诊断；2）为特定治疗方案选择患者；3）跟踪治疗反应；4）预后价值。液体生物群是指包括血液、尿液和脑脊液在内的生物体液的组合，其中含有少量的肿瘤细胞、DNA/RNA 编码物质、肽和代谢物。在液体生物群中，有 2 种广泛存在的生物标志物：肿瘤衍生的生物标志物，可直接追溯到肿瘤；以及肿瘤相关的生物标志物，可追溯到机体对疾病的反应。尽管肿瘤相关的生物标志物是很有前途的液体活检候选物，但最近在生物标志物富集和检测方面的进展使人们能够集中研究一类新的生物标志物：肿瘤衍生的生物标志物。本综述重点介绍了这两种生物标志物类别之间的区别，并强调了有前景的新方向。
