Mishra Sridhar, Kumari Swati, Husain Nuzhat
Department of Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226010, India.
Department of Plastic and Reconstructive Surgery, King George Medical University, Lucknow, Uttar 1pradesh, 226003, India.
J Liq Biopsy. 2024 Nov 26;6:100280. doi: 10.1016/j.jlb.2024.100280. eCollection 2024 Dec.
Although there have been significant advances in the early detection and treatment of gallbladder cancer (GBC), it is still considered a leading cause of morbidity and mortality. Molecular profiling of tumors is generally performed using samples obtained during surgery or biopsy. However, tissue genotyping has its limitations as it only provides a single snapshot and is susceptible to spatial selection bias due to the tumor heterogeneity. Over the past decade, there has been a remarkable transition from invasive diagnostic methods to non-invasive alternatives, including liquid biopsy, for cancer diagnosis and monitoring. Liquid biopsies have ushered in a new era in clinical oncology, enabling convenient tumor sampling, continuous monitoring through repeated analysis, development of personalized treatment regimens, and assessment of therapy resistance. While peripheral blood is the primary medium for these biopsies, other biological fluids, including urine, saliva, and bile, also serve as valuable sources of information. Currently, the focus of blood-based biopsy analyses is on four main sources of biomarkers for cancer detection and stratification: circulating tumor DNA (ctDNA) or circulating free DNA (cfDNA), circulating tumor cells (CTCs), and extracellular vesicle (EVs). There are over 300 clinical trials either ongoing or actively recruiting participants to investigate the diagnostic and prognostic applications of ctDNA/cfDNA in the context of cancer. This review outlines the current standard of care for individuals with GBC, anticipates future treatment developments, and evaluates the potential applications of liquid biopsies in various clinical contexts. The review addresses ctDNA/cfDNA, CTC, and circulating microRNA and highlights their prospective roles in management of GBC.
尽管在胆囊癌（GBC）的早期检测和治疗方面取得了重大进展，但它仍然被认为是发病和死亡的主要原因。肿瘤的分子分析通常使用手术或活检时获得的样本进行。然而，组织基因分型有其局限性，因为它只提供一个单一的快照，并且由于肿瘤异质性而易受空间选择偏差的影响。在过去十年中，从侵入性诊断方法到非侵入性替代方法，包括液体活检，在癌症诊断和监测方面发生了显著转变。液体活检开创了临床肿瘤学的新纪元，实现了便捷的肿瘤采样、通过重复分析进行连续监测、个性化治疗方案的制定以及治疗耐药性的评估。虽然外周血是这些活检的主要介质，但其他生物体液，包括尿液、唾液和胆汁，也作为有价值的信息来源。目前，基于血液的活检分析重点关注癌症检测和分层的四种主要生物标志物来源：循环肿瘤DNA（ctDNA）或循环游离DNA（cfDNA）、循环肿瘤细胞（CTC）和细胞外囊泡（EV）。有300多项正在进行或正在积极招募参与者的临床试验，以研究ctDNA/cfDNA在癌症背景下的诊断和预后应用。本综述概述了GBC患者的当前护理标准，预测未来的治疗发展，并评估液体活检在各种临床环境中的潜在应用。该综述涉及ctDNA/cfDNA、CTC和循环微小RNA，并强调了它们在GBC管理中的前瞻性作用。
