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超越检测:胃肠道癌症中的传统生物标志物与新兴生物标志物

Beyond Detection: Conventional and Emerging Biomarkers in Gastrointestinal Cancers.

作者信息

Han Daniel M, Wakefield Mark R, Fang Yujiang

机构信息

Department of Microbiology, Immunology & Pathology, Des Moines University, West Des Moines, IA 50266, USA.

Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA.

出版信息

Cancers (Basel). 2025 Aug 22;17(17):2725. doi: 10.3390/cancers17172725.

Abstract

Gastrointestinal (GI) cancers, particularly colorectal and gastric cancers, majorly contribute to global cancer mortality due to frequent late-stage diagnosis and poor therapeutic response in advanced disease. Earlier detection of GI cancers is needed for a better prognosis. This review examines both traditional and emerging biomarkers that contribute significantly to early detection, prognostication, and prediction of therapeutic resistance or sensitivity. Specifically, we highlight the diagnostic utility of non-invasive liquid biopsy biomarkers such as circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomes. Moreover, we discuss the prognostic and predictive value of conventional genetic alterations, including KRAS, BRAF, and HER2. Although new findings have shown the advantages of liquid biopsy over colonoscopy, there are still limitations to the technique, such as cost-effectiveness, technological gaps in low-resource settings, and uncertain detection rates. Further studies are required to test the validity and accessibility of liquid biopsy and its biomarkers in order to advance personalized diagnosis and treatments for GI cancers. Such a study will be helpful for clinicians to better manage patients with GI cancers.

摘要

胃肠道(GI)癌症,尤其是结直肠癌和胃癌,由于晚期诊断频繁且晚期疾病的治疗反应不佳,在全球癌症死亡率中占主要比例。需要更早地检测出胃肠道癌症以获得更好的预后。本综述探讨了对早期检测、预后评估以及治疗耐药性或敏感性预测有重大贡献的传统生物标志物和新兴生物标志物。具体而言,我们重点介绍了非侵入性液体活检生物标志物的诊断效用,如循环肿瘤DNA(ctDNA)、微小RNA(miRNA)和外泌体。此外,我们还讨论了包括KRAS、BRAF和HER2在内的传统基因改变的预后和预测价值。尽管新的研究结果显示了液体活检相对于结肠镜检查的优势,但该技术仍存在局限性,如成本效益、低资源环境中的技术差距以及不确定的检测率。需要进一步研究来测试液体活检及其生物标志物的有效性和可及性,以推进胃肠道癌症的个性化诊断和治疗。这样的研究将有助于临床医生更好地管理胃肠道癌症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e68/12427498/f7636aa84116/cancers-17-02725-g001.jpg

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