循环肿瘤DNA在肿瘤精准治疗中的意义

Significance of circulating tumor DNA in precise treatment of tumor

活组织检查不仅是癌症诊断的标准,还适用于癌症的靶向治疗.然而由于肿瘤异质性和不断演化的特点,使得活组织检查在用于癌症诊断、发展评估、预后和基因分型时有一定局限性.循环肿瘤DNA（ctDNA）是由肿瘤细胞释放到血液循环系统中的DNA,能实时反映肿瘤状态.随着新技术不断涌现,检测ctDNA的特异性及灵敏性的方法 不断改善.对ctDNA检测可以用来分析肿瘤基因和表观遗传的改变,ctDNA能够广泛应用于肿瘤分子分型、评估肿瘤动态和肿瘤负荷、检测微小残留病灶和复发、预后评估、监测耐药和发现新治疗靶点.

Tissue biopsy is a diagnostic standard as well as the targeted therapy of cancer. However, tissue biopsy has some limitations in the cancer diagnosis , assessment of cancer development, prognosis and genotyping due to tumor heterogeneity and evolution. Circulating tumor DNA （ctDNA） is a kind of circulating DNA fragments released by the tumor cells into the circulation system reflecting the state of tumors. With the emergence of new technology, the ways to detect the specificity and sensitivity of ctDNA have been improved greatly. Furthermore, detection of ctDNA could analyze oncogene and epigenetic changes, which has been widely used in molecular subtyping, assessment of tumor dynamic and burden, evaluation of minimal residual disease and recurrence, prognosis assessment, monitoring of drug resistance and exploration of new therapeutic targets.