Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-Machi, Kanazawa, Ishikawa, 920-8641, Japan.
Brain Tumor Pathol. 2023 Apr;40(2):66-77. doi: 10.1007/s10014-023-00452-x. Epub 2023 Feb 17.
An ideal biomarker must meet several parameters to enable its successful adoption; however, the nature of glioma makes it challenging to discover valuable biomarkers. While biomarkers require simplicity for clinical implementation, anatomical features and the complexity of the brain make it challenging to perform histological examination. Therefore, compared to biomarkers from general histological examination, liquid biomarkers for brain disease offer many more advantages in these minimally invasive methods. Ideal biomarkers should have high sensitivity and specificity, especially in malignant tumors. The heterogeneous nature of glioma makes it challenging to determine useful common biomarkers, and no liquid biomarker has yet been adopted clinically. The low incidence of brain tumors also hinders research progress. To overcome these problems, clinical applications of new types of specimens, such as extracellular vesicles and comprehensive omics analysis, have been developed, and some candidate liquid biomarkers have been identified. As against previous reviews, we focused on and reviewed the sensitivity and specificity of each liquid biomarker for its clinical application. Perusing an ideal glioma biomarker would help uncover the common underlying mechanism of glioma and develop new therapeutic targets. Further multicenter studies based on these findings will help establish new treatment strategies in the future.
一个理想的生物标志物必须满足几个参数才能成功应用；然而，胶质瘤的性质使得发现有价值的生物标志物具有挑战性。虽然生物标志物需要简单化才能在临床上实施，但由于解剖学特征和大脑的复杂性，进行组织学检查具有挑战性。因此，与一般组织学检查的生物标志物相比，用于脑部疾病的液体生物标志物在这些微创方法中具有更多的优势。理想的生物标志物应该具有高灵敏度和特异性，特别是在恶性肿瘤中。胶质瘤的异质性使得确定有用的常见生物标志物变得具有挑战性，并且尚未在临床上采用任何液体生物标志物。脑肿瘤的发病率低也阻碍了研究进展。为了克服这些问题，已经开发了新型标本的临床应用，例如细胞外囊泡和综合组学分析，并确定了一些候选液体生物标志物。与以前的综述不同，我们专注于并回顾了每种液体生物标志物在其临床应用中的灵敏度和特异性。研究理想的胶质瘤生物标志物将有助于揭示胶质瘤的共同潜在机制，并开发新的治疗靶点。基于这些发现的进一步多中心研究将有助于未来建立新的治疗策略。
