Department of Pulmonary and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Respiratory Health and Multimorbidity, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Cancer Lett. 2023 Nov 28;577:216365. doi: 10.1016/j.canlet.2023.216365. Epub 2023 Aug 25.
Lung cancer maintains high morbidity and mortality rate globally despite significant advancements in diagnosis and treatment in the era of precision medicine. Pathological analysis of tumor tissue, the current gold standard for lung cancer diagnosis, is intrusive and intrinsically confined to evaluating the limited amount of tissues that could be physically extracted. However, tissue biopsy has several limitations, including the invasiveness of the procedure and difficulty in obtaining samples for patients at advanced stages., there Additionally,has been no major breakthrough in tumor biomarkers with high specificity and sensitivity, particularly for early-stage lung cancer. Liquid biopsy has been considered a feasible auxiliary tool for tearly dianosis, evaluating treatment responses and monitoring prognosis of lung cancer. Circulating tumor DNA (ctDNA), an ideal biomarker of liquid biopsy, has emerged as one of the most reliable tools for monitoring tumor processes at molecular levels. Herein, this review focuses on tumor heterogeneity to elucidate the superiority of liquid biopsy and retrospectively discussdeciphersolution. We systematically elaborate ctDNA biological characteristics, introduce methods for ctDNA detection, and discuss the current role of plasma ctDNA in lung cancer management. Finally, we summarize the drawbacks of ctDNA analysis and highlight its potential clinical application in lung cancer.
尽管在精准医学时代，肺癌的诊断和治疗取得了重大进展，但全球范围内肺癌的发病率和死亡率仍居高不下。肿瘤组织的病理分析是目前肺癌诊断的金标准，但具有侵入性，本质上局限于评估可以物理提取的有限量的组织。然而，组织活检有几个局限性，包括该过程的侵入性以及难以获得晚期患者的样本。此外，在具有高特异性和灵敏度的肿瘤生物标志物方面尚未取得重大突破，尤其是对于早期肺癌。液体活检被认为是早期诊断、评估治疗反应和监测肺癌预后的一种可行的辅助工具。循环肿瘤 DNA（ctDNA）作为液体活检的理想生物标志物，已成为监测肿瘤分子水平进程最可靠的工具之一。本文重点关注肿瘤异质性，以阐明液体活检的优势，并回顾性地探讨解决方案。我们系统地阐述了 ctDNA 的生物学特征，介绍了 ctDNA 检测方法，并讨论了目前血浆 ctDNA 在肺癌管理中的作用。最后，我们总结了 ctDNA 分析的缺点，并强调了其在肺癌中的潜在临床应用。
