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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (9): 64-71.doi: 10.6040/j.issn.1671-7554.0.2021.1091

• 专家综述 • 上一篇    下一篇

肿瘤液体活检

王传新1,2   

  1. 1.山东大学第二医院检验医学中心, 山东 济南 250033;2.山东省肿瘤标志物检测工程实验室, 山东 济南 250033
  • 发布日期:2021-10-15
  • 通讯作者: 王传新. E-mail:cxwang@sdu.edu.cn
  • 基金资助:
    国家自然科学基金重点项目(21020307182549500);山东省重点研发计划国际合作项目(2019GHZ003)

Liquid biopsy of tumor

WANG Chuanxin1,2   

  1. 1. Department of Clinical Laboratory, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China;
    2. Tumor Marker Detection Engineering Laboratory of Shandong Provine, Jinan 250033, Shandong, China
  • Published:2021-10-15

摘要: 肿瘤是危害人类健康的重大疾病,其复杂性和异质性使得肿瘤诊疗进展缓慢。精准医疗促使肿瘤诊疗方式朝着更加精细化、个体化的方向发展,分子诊断技术和靶向治疗正逐步应用于肿瘤临床诊疗过程。液体活检技术能够通过患者体液反映疾病状态,无创且能提供动态丰富的肿瘤相关分子信息,在肿瘤早期预警及辅助诊断、疗效实时监测、用药指导和耐药机制探索、预后判断和风险分级、靶向药物伴随诊断等方面具有巨大应用潜能,受到临床的广泛关注。论文将针对液体活检的分类、临床应用及未来发展等方面,综述液体活检在肿瘤精准诊疗中的最新进展。

关键词: 肿瘤, 液体活检, 分子诊断, 临床应用, 精准医疗

Abstract: Tumor, whose complexity and heterogeneity make the progress of tumor diagnosis and treatment slow, is damaging human life and health. Precision medicine promotes the development of tumor diagnosis and treatment in a more refined and individual direction, and molecular diagnostic techniques and targeted therapy are gradually being applied in the clinical diagnosis and treatment of tumors. Liquid biopsy can reflect disease status through a patients body fluids. It is noninvasive and able to provide dynamic and rich molecular information, thus, it has great potential in the early detection and auxiliary diagnosis, real time monitoring of treatment efficacy, guidance of drug use and exploration of mechanism in drug resistance, prognosis and risk stratification, and concomitant diagnosis of targeted drugs. This review will focus on the classification, clinical application, as well as future challenges of liquid biopsy in precision oncology and introduce the latest development.

Key words: Tumor, Liquid biopsy, Molecule diagnostics, Clinical application, Precision medicine

中图分类号: 

  • R446.9
[1] Wan JCM, Massie C, Garcia-Corbacho J, et al. Liquid biopsies come of age: Towards implementation of circulating tumour DNA [J]. Nat Rev Cancer, 2017, 17(4): 223-238.
[2] Abbosh C, Birkbak NJ, Wilson GA, et al. Phylogenetic ctdna analysis depicts early-stage lung cancer evolution [J]. Nature, 2017, 545(7655): 446-451.
[3] Ashworth TR. A case of cancer in which cells similar to those in the tumours were seen in the blood after death [J]. Aust Med J, 1969, 14(14): 146-147.
[4] Xia WX, Li HD, Li YQ, et al. In vivo coinstantaneous identification of hepatocellular carcinoma circulating tumor cells by dual-targeting magnetic-fluorescent nanobeads [J]. Nano Lett, 2021, 21(1): 634-641.
[5] Herath S, Razavi Bazaz S, Monkman J, et al. Circulating tumor cell clusters: insights into tumour dissemination and metastasis [J]. Expert Rev Mol Diagn, 2020, 20(11): 1139-1147.
[6] Luo Q, Wang CM, Peng BJ, et al. Circulating tumor-cell-associated white blood cell clusters in peripheral blood indicate poor prognosis in patients with hepatocellular carcinoma [J]. Front Oncol, 2020, 10: 1758. doi:10.3389/fonc.2020.01758.
[7] Smolkova B, Cierna Z, Kalavska K, et al. Increased stromal infiltrating lymphocytes are associated with the risk of disease progression in mesenchymal circulating tumor cell-positive primary breast cancer patients [J]. Int J Mol Sci, 2020, 21(24): 9460.
[8] Pantel K, Speicher MR. The biology of circulating tumor cells [J]. Oncogene, 2016, 35(10): 1216-1224.
[9] Vona G, Sabile A, Louha M, et al. Isolation by size of epithelial tumor cells: a new method for the immunomorphological and molecular characterization of circulatingtumor cells [J]. Am J Pathol, 2000, 156(1): 57-63.
[10] Riethdorf S, Fritsche H, Müller V, et al. Detection of circulating tumor cells in peripheral blood of patients with metastatic breast cancer: a validation study of the cellsearch system [J]. Clin Cancer Res, 2007, 13(3): 920-928.
[11] Spellman PT, Gray JW. Detecting cancer by monitoring circulating tumor DNA [J]. Nat Med, 2014, 20(5): 474-475.
[12] Kahlert C, Kalluri R. Exosomes in tumor microenvironment influence cancer progression and metastasis [J]. J Mol Med(Berl), 2013, 91(4): 431-437.
[13] Greening DW, Xu R, Ji H, et al. A protocol for exosome isolation and characterization: evaluation of ultracentrifugation, density-gradient separation, and immunoaffinity capture methods [J]. Methods Mol Biol, 2015, 1295: 179-209. doi:10.1007/978-1-4939-2550-6_15.
[14] Saaoud F, Drummer IVC, Shao Y, et al. Circular rnas are a novel type of non-coding rnas in ros regulation, cardiovascular metabolic inflammations and cancers [J]. Pharmacol Ther, 2020: 107715. doi:10.1016/j.pharmthera.2020.107715.
[15] Xie Y, Li J, Li P, et al. Rna-seq profiling of serum exosomal circular rnas reveals circ-pnn as a potential biomarker for human colorectal cancer [J]. Front Oncol, 2020, 10: 982. doi:10.3389/fonc.2020.00982.
[16] Zhao Y, Du T, Du L, et al. Long noncoding rna linc02418 regulates melk expression by acting as a cerna and may serve as a diagnostic marker for colorectal cancer [J]. Cell Death Dis, 2019, 10(8): 568.
[17] Katz RL, He W, Khanna A, et al. Genetically abnormal circulating cells in lung cancer patients: an antigen-independent fluorescence in situ hybridization-based case-control study [J]. Clin Cancer Res, 2010, 16(15): 3976-3987.
[18] Katz RL, Zaidi TM, Pujara D, et al. Identification of circulating tumor cells using 4-color fluorescence in situ hybridization: Validation of a noninvasive aid for ruling out lung cancer in patients with low-dose computed tomography-detected lung nodules [J]. Cancer Cytopathol, 2020, 128(8): 553-562.
[19] Goveia J, Rohlenova K, Taverna F, et al. An integrated gene expression landscape profiling approach to identify lung tumor endothelial cell heterogeneity and angiogenic candidates [J]. Cancer Cell, 2020, 37(3): 421.
[20] Brinkman K, Meyer L, Bickel A, et al. Extracellular vesicles from plasma have higher tumour rna fraction than platelets [J]. J Extracell Vesicles, 2020, 9(1): 1741176.
[21] Best MG, Sol N, In 't Veld SGJG, et al. Swarm intelligence-enhanced detection of non-small-cell lung cancer using tumor-educated platelets [J]. Cancer Cell, 2017, 32(2): 238-252.
[22] Paweletz CP, Sacher AG, Raymond CK, et al. Bias-corrected targeted next-generation sequencing for rapid, multiplexed detection of actionable alterations in cell-free DNA from advanced lung cancer patients [J]. Clin Cancer Res, 2016, 22(4): 915-922.
[23] Cohen JD, Li L, Wang Y, et al. Detection and localization of surgically resectable cancers with a multi-analyte blood test [J]. Science, 2018, 359(6378): 926-930.
[24] Cohen JD, Javed AA, Thoburn C, et al. Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers [J]. PNAS, 2017, 114(38): 10202-10207.
[25] Kaiser J. ‘Liquid biopsy’ for cancer promises early detection [J]. Science, 2018, 359(6373): 259.
[26] Alix-Panabières C, Pantel K. Clinical applications of circulating tumor cells and circulating tumor DNA as liquid biopsy [J]. Cancer Discov, 2016, 6(5): 479-491.
[27] Sanmamed MF, Fernández-Landázuri S, Rodríguez C, et al. Quantitative cell-free circulating brafv600e mutation analysis by use of droplet digital pcr in the follow-up of patients with melanoma being treated with braf inhibitors [J]. Clin Chem, 2015, 61(1): 297-304.
[28] Oxnard GR, Paweletz CP, Kuang Y, et al. Noninvasive detection of response and resistance in egfr-mutant lung cancer using quantitative next-generation genotyping of cell-free plasma DNA [J]. Clin Cancer Res, 2014, 20(6): 1698-1705.
[29] Geoffrey RO, Alexander ED, Manisha HS, et al. Detection and clearance of RET variants in plasma cell free DNA(cfDNA)from patients(pts)treated with loxo-292. [J]. J Clin Oncol, 2018, 36(15): 9048-9048.
[30] Frances AS, Papadimitrakopoulou V, Tony M, et al. Early clearance of plasma egfr mutations as a predictor of response to osimertinib in the aura3 trial. [J]. J Clin Oncol, 2018, 36(15): 9027-9027.
[31] Hyman DM, Smyth LM, Donoghue MTA, et al. Akt inhibition in solid tumors with akt1 mutations [J]. J Clin Oncol, 2017, 35(20): 2251-2259.
[32] Choudhury AD, Werner L, Francini E, et al. Tumor fraction in cell-free DNA as a biomarker in prostate cancer [J]. JCI Insight, 2018, 3(21): 122109.
[33] Goodall J, Assaf ZJ, Shi Z, et al. Circulating tumor DNA(ctdna)dynamics associate with treatment response and radiological progression-free survival(rpfs): Analyses from a randomized phase ii trial in metastatic castration-resistant prostate cancer(mcrpc)[J]. J Clin Oncol, 2020, 38(15): 5508-5508.
[34] Zheng MM, Li YS, Tu HY, et al. Genotyping of cerebrospinal fluid associated with osimertinib response and resistance for leptomeningeal metastases in egfr-mutated nsclc [J]. J Thorac Oncol, 2021, 16(2): 250-258.
[35] Ococks E, Frankell AM, Masque Soler N, et al. Longitudinal tracking of 97 esophageal adenocarcinomas using liquid biopsy sampling [J]. Ann Oncol, 2021, 32(4): 522-532.
[36] 林铖, 姜傥. 液体活检技术在非小细胞肺癌患者EGFR-TKI继发耐药中的应用 [J]. 检验医学, 2016, 31(10): 835-843. LIN Cheng, JIANG Tang. Liquid biopsy for monitoring EGFR-TKI drug resistance in patients with non-small-cell lung cancer [J]. Laboratory Medicine, 2016, 31(10): 835-843.
[37] 刘志刚, 施奇惠. 基于液体活检与二代测序解析肺腺癌患者靶向药耐药机制[J]. 基因组学与应用生物学, 2021, 40(3): 1348-1355. LIU Zhigang, SHI Qihui.Deciphering resistance mechanism of targeted therapy in lung adenocarcinoma patients based on liquid biopsy and next-generation sequencing [J]. Genomics and Applied Biology, 2021, 40(3): 1348-1355.
[38] Castellanos-Rizaldos E, Grimm DG, Tadigotla V, et al. Exosome-based detection of egfr t790m in plasma from non-small cell lung cancer patients [J]. Clin Cancer Res, 2018, 24(12): 2944-2950.
[39] Hur JY, Kim HJ, Lee JS, et al. Extracellular vesicle-derived DNA for performing egfr genotyping of nsclc patients [J]. Mol Cancer, 2018, 17(1): 15.
[40] Sundaresan TK, Sequist LV, Heymach JV, et al. Detection of t790m, the acquired resistance egfr mutation, by tumor biopsy versus noninvasive blood-based analyses [J]. Clin Cancer Res, 2016, 22(5): 1103-1110.
[41] Zheng D, Ye X, Zhang MZ, et al. Plasma egfr t790m ctdna status is associated with clinical outcome in advanced nsclc patients with acquired egfr-tki resistance [J]. Sci Rep, 2016, 6: 20913. doi:10.1038/srep20913.
[42] Mao C, Yuan JQ, Yang ZY, et al. Blood as a substitute for tumor tissue in detecting egfr mutations for guiding egfr tkis treatment of nonsmall cell lung cancer: A systematic review and meta-analysis [J]. Medicine(Baltimore), 2015, 94(21): e775.
[43] Best MG, Sol N, Kooi I, et al. Rna-seq of tumor-educated platelets enables blood-based pan-cancer, multiclass, and molecular pathway cancer diagnostics [J]. Cancer Cell, 2015, 28(5): 666-676.
[44] Hrebien S, Citi V, Garcia-Murillas I, et al. Early ctdna dynamics as a surrogate for progression-free survival in advanced breast cancer in the beech trial [J]. Ann Oncol, 2019, 30(6): 945-952.
[45] Goldberg SB, Narayan A, Kole AJ, et al. Early assessment of lung cancer immunotherapy response via circulating tumor DNA [J]. Clin Cancer Res, 2018, 24(8): 1872-1880.
[46] Santiago-Walker A, Gagnon R, Mazumdar J, et al. Correlation of braf mutation status in circulating-free DNA and tumor and association with clinical outcome across four brafi and meki clinical trials [J]. Clin Cancer Res, 2016, 22(3): 567-574.
[47] Pietrasz D, Pécuchet N, Garlan F, et al. Plasma circulating tumor DNA in pancreatic cancer patients is a prognostic marker [J]. Clin Cancer Res, 2017, 23(1): 116-123.
[48] Lapin M, Oltedal S, Tjensvoll K, et al. Fragment size and level of cell-free DNA provide prognostic information in patients with advanced pancreatic cancer [J]. J Transl Med, 2018, 16(1): 300.
[49] Bernard V, Kim DU, San Lucas FA, et al. Circulating nucleic acids are associated with outcomes of patients with pancreatic cancer [J]. Gastroenterology, 2019, 156(1): 108-118.
[50] Nanou A, Mol L, Coumans FAW, et al. Endothelium-derived extracellular vesicles associate with poor prognosis in metastatic colorectal cancer [J]. Cells, 2020, 9(12): 2688.
[51] 中国临床肿瘤学会非小细胞肺癌专家委员会. 二代测序技术在NSCLC中的临床应用中国专家共识(2020版)[J]. 中国肺癌杂志, 2020, 23(9): 741-761.
[52] 中华医学会检验医学分会, 国家卫生健康委员会临床检验中心. 液体活检在临床肿瘤诊疗应用和医学检验实践中的专家共识[J]. 中华检验医学杂志, 2018, 41(10): 724-733.
[53] Chalmers ZR, Connelly CF, Fabrizio D, et al. Analysis of 100,000 human cancer genomes reveals the landscape of tumor mutational burden [J]. Genome Med, 2017, 9(1): 34.
[54] Oliveira AF, Bretes L, Furtado I. Review of pd-1/pd-l1 inhibitors in metastatic dmmr/msi-h colorectal cancer [J]. Front Oncol, 2019, 9: 396. doi:10.3389/fonc.2019.00396.
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