Zhang Yingfeng, Tian Libi
University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China.
Heliyon. 2024 Oct 15;10(20):e39148. doi: 10.1016/j.heliyon.2024.e39148. eCollection 2024 Oct 30.
Ovarian cancer, endometrial cancer, and cervical cancer are the three primary gynaecological cancers that pose a significant threat to women's health on a global scale. Enhancing global cancer survival rates necessitates advancements in illness detection and monitoring, with the goal of improving early diagnosis and prognostication of disease recurrence. Conventional methods for identifying and tracking malignancies rely primarily on imaging techniques and, when possible, protein biomarkers found in blood, many of which lack specificity. The process of collecting tumour samples necessitates intrusive treatments that are not suitable for specific purposes, such as screening, predicting, or evaluating the effectiveness of treatment, monitoring the presence of remaining illness, and promptly detecting relapse. Advancements in treatment are being made by the detection of genetic abnormalities in tumours, both inherited and acquired. Newly designed therapeutic approaches can specifically address some of these abnormalities. Liquid biopsy is an innovative technique for collecting samples that examine specific cancer components that are discharged into the bloodstream, such as circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), cell-free RNA (cfRNA), tumour-educated platelets (TEPs), and exosomes. Mounting data indicates that liquid biopsy has the potential to improve the clinical management of gynaecological cancers through enhanced early diagnosis, prognosis prediction, recurrence detection, and therapy response monitoring. Understanding the distinct genetic composition of tumours can also inform therapy choices and the identification of suitable targeted treatments. The main benefits of liquid biopsy are its non-invasive characteristics and practicality, enabling the collection of several samples and the continuous monitoring of tumour changes over time. This review aims to provide an overview of the data supporting the therapeutic usefulness of each component of liquid biopsy. Additionally, it will assess the benefits and existing constraints associated with the use of liquid biopsy in the management of gynaecological malignancies. In addition, we emphasise future prospects in light of the existing difficulties and investigate areas where further research is necessary to clarify its rising clinical capabilities.
卵巢癌、子宫内膜癌和宫颈癌是全球范围内对女性健康构成重大威胁的三种主要妇科癌症。提高全球癌症生存率需要在疾病检测和监测方面取得进展，目标是改善疾病复发的早期诊断和预后。识别和追踪恶性肿瘤的传统方法主要依赖成像技术，以及在可能的情况下依赖血液中发现的蛋白质生物标志物，其中许多缺乏特异性。采集肿瘤样本的过程需要侵入性治疗，而这些治疗不适用于某些特定目的，如筛查、预测或评估治疗效果、监测残留疾病的存在以及及时检测复发。通过检测肿瘤中的遗传异常（包括遗传性和获得性），治疗正在取得进展。新设计的治疗方法可以专门针对其中一些异常情况。液体活检是一种创新的样本采集技术，可检测释放到血液中的特定癌症成分，如循环肿瘤DNA（ctDNA）、循环肿瘤细胞（CTC）、游离RNA（cfRNA）、肿瘤诱导血小板（TEP）和外泌体。越来越多的数据表明，液体活检有可能通过加强早期诊断、预后预测、复发检测和治疗反应监测来改善妇科癌症的临床管理。了解肿瘤独特的基因组成也可以为治疗选择和确定合适的靶向治疗提供依据。液体活检的主要优点是其非侵入性特点和实用性，能够采集多个样本并随时间持续监测肿瘤变化。本综述旨在概述支持液体活检各成分治疗效用的数据。此外，它将评估在妇科恶性肿瘤管理中使用液体活检的益处和现有限制。此外，我们根据现有困难强调未来前景，并探讨需要进一步研究以阐明其不断提高的临床能力的领域。
