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[脑脊液循环肿瘤DNA在非小细胞肺癌软脑膜转移中的临床应用进展]

[Advances in Clinical Application of Cerebrospinal Fluid Circulating Tumor DNA 
in Leptomeningeal Metastasis of Non-small Cell Lung Cancer].

作者信息

Li Yubin, Li Xiaoyan

机构信息

Department of Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2024 May 20;27(5):376-382. doi: 10.3779/j.issn.1009-3419.2024.102.16.

DOI:10.3779/j.issn.1009-3419.2024.102.16
PMID:38880925
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11183312/
Abstract

Leptomeningeal metastasis (LM) is a lethal complication of malignant tumors, with an incidence rate of 3%-5% among patients with non-small cell lung cancer (NSCLC). LM poses significant challenges in diagnosis, has poor prognosis, limited treatment options, and lacks standardized criteria for evaluating therapeutic efficacy, making it a difficult aspect of NSCLC management. Circulating tumor DNA (ctDNA), shed from tumor cells and carrying cancer-related information, holds significant value in precision oncology. Cerebrospinal fluid (CSF), present in the subarachnoid space of the brain, the spinal cord, and the central canal, and in direct contact with meningeal tissues, serves as the fluid medium that best reflects the genetic characteristics of LM. In recent years, CSF ctDNA has become a focal point due to its multi-omics features, playing a crucial role in the management of central nervous system (CNS) metastatic tumors. Its applications span the entire continuum of care, including aiding in diagnosis, assessing treatment response, predicting prognosis, and analyzing resistance mechanisms. This article provides a concise overview of CSF ctDNA detection techniques and their clinical applications in patients with NSCLC-LM.
.

摘要

软脑膜转移(LM)是恶性肿瘤的一种致命并发症,在非小细胞肺癌(NSCLC)患者中的发生率为3% - 5%。LM在诊断方面面临重大挑战,预后较差,治疗选择有限,且缺乏评估治疗效果的标准化标准,这使其成为NSCLC管理中的一个难题。循环肿瘤DNA(ctDNA)由肿瘤细胞释放并携带癌症相关信息,在精准肿瘤学中具有重要价值。脑脊液(CSF)存在于脑、脊髓的蛛网膜下腔以及中央管内,与脑膜组织直接接触,是最能反映LM基因特征的液体介质。近年来,CSF ctDNA因其多组学特征成为研究热点,在中枢神经系统(CNS)转移性肿瘤的管理中发挥着关键作用。其应用贯穿整个治疗过程,包括辅助诊断、评估治疗反应、预测预后以及分析耐药机制。本文简要概述了CSF ctDNA检测技术及其在NSCLC-LM患者中的临床应用。

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本文引用的文献

1
Liquid Biopsy Response Evaluation Criteria in Solid Tumors (LB-RECIST).液体活检实体瘤反应评估标准(LB-RECIST)。
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Utilizing phenotypic characteristics of metastatic brain tumors to improve the probability of detecting circulating tumor DNA from cerebrospinal fluid in non-small-cell lung cancer patients: development and validation of a prediction model in a prospective cohort study.利用转移性脑肿瘤的表型特征提高非小细胞肺癌患者脑脊液中循环肿瘤 DNA 的检测概率:前瞻性队列研究中预测模型的建立和验证。
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