Li Huei-Ying, Chang Chun-Chuan, Yang Yu-Hsuan, Yao Chi-Yuan, Chia-Hsun Hsieh Jason, Chang Shao-Hsuan
Medical Microbiota Center of the First Core Laboratory, National Taiwan University, Taipei, Taiwan.
Professional Master's Program of Biotechnology Management, National Taiwan University, Taipei, Taiwan.
J Liq Biopsy. 2025 Mar 6;7:100290. doi: 10.1016/j.jlb.2025.100290. eCollection 2025 Mar.
Liquid biopsy is a promising, non-invasive diagnostic tool for cancer, offering rapid and cost-effective genomic analysis. It provides a less invasive alternative to traditional tissue biopsies, with potential benefits in monitoring disease progression and detecting minimal residual disease (MRD). However, its clinical integration faces challenges, including utility assessment and workflow adaptation. This study evaluates the value of liquid biopsy in Taiwan from a clinical physician's perspective.
A survey was conducted with 16 physicians specializing in thoracic medicine and hematologic oncology. Participants responded to a 5-point Likert scale to evaluate the timing of liquid biopsy adoption, willingness to incorporate it into clinical practice, and agreement on its role in managing specific clinical conditions.
Forty percent of physicians preferred liquid biopsy when tissue samples were unavailable. The inclusion of liquid biopsy under National Health Insurance (NHI) was a key factor in its adoption. Hematologic oncologists showed a stronger preference for liquid biopsy, particularly for MRD testing, compared to their counterparts in thoracic medicine (hematologic oncology vs. thoracic medicine: 4.2 ± 0.83 vs. 3.1 ± 0.60; p value = 0.01). Younger physicians valued turnaround time, while senior physicians prioritized test brand, with a focus on report speed.
Physicians are generally less inclined to replace tissue biopsies with liquid biopsy, but hematologic oncologists show more flexibility. Test brand plays a role in physician decision-making, and the inclusion of liquid biopsy under NHI coverage is vital for its broader adoption in Taiwan.
液体活检是一种很有前景的癌症无创诊断工具，可提供快速且具成本效益的基因组分析。它为传统组织活检提供了一种侵入性较小的替代方法，在监测疾病进展和检测微小残留病（MRD）方面具有潜在优势。然而，其临床整合面临挑战，包括效用评估和工作流程调整。本研究从临床医生的角度评估台湾液体活检的价值。
对16名胸科医学和血液肿瘤学专家进行了一项调查。参与者以5分李克特量表回答，以评估采用液体活检的时机、将其纳入临床实践的意愿以及对其在管理特定临床情况中作用的认同。
40%的医生在无法获取组织样本时更倾向于液体活检。将液体活检纳入国民健康保险（NHI）是其被采用的关键因素。与胸科医学医生相比，血液肿瘤学医生对液体活检表现出更强的偏好，尤其是在MRD检测方面（血液肿瘤学与胸科医学：4.2±0.83对3.1±0.60；p值=0.01）。年轻医生重视周转时间，而资深医生则优先考虑检测品牌，重点是报告速度。
医生一般不太倾向于用液体活检取代组织活检，但血液肿瘤学医生表现出更大的灵活性。检测品牌在医生决策中起作用，将液体活检纳入NHI覆盖范围对其在台湾更广泛的应用至关重要。
