Baraniskin Alexander, Baba Hideo A, Theegarten Dirk, Mika Thomas, Schroers Roland, Klein-Scory Susanne
Department of Hematology and Oncology, Evangelisches Krankenhaus Hamm, Hamm, Germany.
Department of Medicine, Hematology and Oncology, University Hospital Knappschaftskrankenhaus Bochum GmbH, Ruhr University of Bochum, Bochum, Germany.
Front Oncol. 2023 May 3;13:1141833. doi: 10.3389/fonc.2023.1141833. eCollection 2023.
In the context of colorectal cancer (CRC), circulating tumor DNA (ctDNA) is frequently used to monitor the minimal residual disease (MRD). ctDNA has become an excellent biomarker to predict which patients with CRC are likely to relapse due to the persistence of micrometastases. MRD diagnosis analysis of ctDNA may allow much earlier detection of relapse compared with conventional diagnosis during follow-up. It should lead to an increased rate of curative-intended complete resection of an asymptomatic relapse. Besides, ctDNA can provide crucial information on whether and how intensively adjuvant or additive therapy should be administered. In the present case, analysis of ctDNA gave us a crucial hint to the use of more intensive diagnostics (MRI and Positron emission tomography-computed tomography PET-CT) which led to earlier detection of CRC relapse. Metastasis detected early are more likely to be completely resectable with curative intent.
在结直肠癌（CRC）的背景下，循环肿瘤DNA（ctDNA）经常被用于监测微小残留病（MRD）。由于微转移的持续存在，ctDNA已成为预测哪些CRC患者可能复发的优秀生物标志物。与随访期间的传统诊断相比，ctDNA的MRD诊断分析可能会更早地检测到复发。这应该会提高无症状复发的根治性完全切除率。此外，ctDNA可以提供关于是否以及应如何强化进行辅助或附加治疗的关键信息。在本病例中，ctDNA分析为我们使用更强化的诊断方法（磁共振成像（MRI）和正电子发射断层扫描-计算机断层扫描（PET-CT））提供了关键线索，从而更早地检测到CRC复发。早期检测到的转移更有可能通过根治性意图完全切除。
