HBP and Multi Organ Transplant Program, Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Ann Surg Oncol. 2023 Jun;30(6):3849-3863. doi: 10.1245/s10434-023-13126-x. Epub 2023 Feb 20.
In this review, we present the current evidence and future perspectives on the use of circulating tumour DNA (ctDNA) in the diagnosis, management and understanding the prognosis of patients with intrahepatic cholangiocarcinoma (iCCA) undergoing surgery. Liquid biopsies or ctDNA maybe utilized to: (1) determine the molecular profile of the tumour and therefore guide the selection of molecular targeted therapy in the neoadjuvant setting, (2) form a surveillance tool for the detection of minimal residual disease or cancer recurrence after surgery, and (3) diagnose and screen for early iCCA detection in high-risk populations. The potential for ctDNA can be tumour-informed or -uninformed depending on the goals of its use. Future studies will require ctDNA extraction technique validations, with standardizations of both the platforms and the timing of ctDNA collections.
在这篇综述中，我们介绍了循环肿瘤 DNA（ctDNA）在手术治疗的肝内胆管癌（iCCA）患者的诊断、管理和预后评估中的应用的现有证据和未来展望。液体活检或 ctDNA 可用于：（1）确定肿瘤的分子特征，从而指导新辅助治疗中分子靶向治疗的选择；（2）作为手术后微小残留病灶或癌症复发检测的监测工具；（3）诊断和筛查高危人群中的早期 iCCA。ctDNA 的潜在价值取决于其应用目的，可以是基于肿瘤信息的，也可以是无肿瘤信息的。未来的研究需要对 ctDNA 提取技术进行验证，并对平台和 ctDNA 采集时间进行标准化。
