Savino Francesco D, Rigali Fabio, Giustini Viviana, D'Aliberti Deborah, Spinelli Silvia, Piazza Rocco, Sacco Antonio, Roccaro Aldo M
Clinical Research Development and Phase I Unit, ASST Spedali Civili di Brescia, 25121 Brescia, Italy.
Clinical Chemistry Laboratory, Flow Cytometry Unit, ASST Spedali Civili di Brescia, 25121 Brescia, Italy.
Cancers (Basel). 2022 Oct 31;14(21):5378. doi: 10.3390/cancers14215378.
Within the context of precision medicine, the scientific community is giving particular attention to early diagnosis and intervention, guided by non-invasive methodologies. Liquid biopsy (LBx) is a recent laboratory approach consisting of a non-invasive blood draw, which allows the detection of information about potential prognostic factors, or markers to be used for diagnostic purposes; it might also allow the clinician to establish a treatment regimen and predict a patient's response. Since the discovery of circulating tumor cells (CTCs) in the nineteenth century, the possibility of integrating LBx into clinical practice has been explored, primarily because of its safeness and easy execution: indeed, compared to solid biopsy, sampling-related risks are less of a concern, and the quickness and repeatability of the process could help confirm a prompt diagnosis or to further corroborate the existence of a metastatic spreading of the disease. LBx's usefulness has been consolidated in a narrow range of oncological settings, first of all, non-small cell lung carcinoma (NSCLC), and it is now gradually being assessed also in lymphoproliferative diseases, such as acute lymphocytic leukemia (ALL), B-cell lymphomas, and multiple myeloma. The present review aims to summarize LBx's overall characteristics (such as its advantages and flaws, collection and analysis methodologies, indications, and targets of the test), and to highlight the applications of this technique within the specific field of B-cell malignancies. The perspectives on how such a simple and convenient technique could improve hemato-oncological clinical practice are broadly encouraging, yet far from a complete integration in routine clinical settings.
在精准医学的背景下,科学界特别关注早期诊断和干预,以非侵入性方法为指导。液体活检(LBx)是一种最新的实验室方法,包括进行一次非侵入性的采血,它能够检测有关潜在预后因素或用于诊断目的的标志物的信息;还可能使临床医生制定治疗方案并预测患者的反应。自19世纪发现循环肿瘤细胞(CTC)以来,人们一直在探索将液体活检纳入临床实践的可能性,主要是因为其安全性和易于实施:实际上,与实体活检相比,与采样相关的风险更无需担忧,而且该过程的快速性和可重复性有助于确认快速诊断或进一步证实疾病转移扩散的存在。液体活检的有用性已在少数肿瘤学环境中得到巩固,首先是在非小细胞肺癌(NSCLC)中,目前也正在对其在淋巴增殖性疾病(如急性淋巴细胞白血病(ALL)、B细胞淋巴瘤和多发性骨髓瘤)中的应用进行逐步评估。本综述旨在总结液体活检的总体特征(如优点和缺点、采集和分析方法、适应症以及检测靶点),并强调该技术在B细胞恶性肿瘤特定领域内的应用。关于这样一种简单便捷的技术如何能够改善血液肿瘤临床实践的前景大体上令人鼓舞,但距离在常规临床环境中的完全整合还很遥远。