过去50年来在癌症研究领域取得了显著进展，深化了对于癌症在概念和生化方面的认识。从将肿瘤视为仅仅由突变细胞简单聚集形成并侧重于检测导致肿瘤发生的关键细胞变化，对于癌症的理解日益扩宽，将癌症视为通过肿瘤和非肿瘤细胞、代谢机制和免疫过程与其近处和远离处的环境相互作用的复杂器官。代谢和免疫系统与肿瘤发生和恶性进展有关，同时存在癌症特异性遗传突变。然而，大多数旨在突破早期癌症检测障碍的技术仅关注基因信息。癌症作为复杂器官的概念推动了其他分析技术的研究，致力于寻找更敏感和经济实惠的全面方法。此外，人工智能作为一种强大工具在肿瘤学界获得了广泛的共识，具有改变医生癌症诊断方式的潜力。本文探讨了将癌症作为与身体环境相互作用的复杂器官的概念的相关性，并侧重于寻找早期癌症诊断的有前景的新兴技术，如液体活检。我们强调全面方法的重要性，以包含与更早癌症检测相关的所有肿瘤和非肿瘤来源信息。©2023年意大利国家癌症研究所“Regina Elena”。

The advances in cancer research achieved in the last 50 years have been remarkable and have provided a deeper knowledge of this disease in many of its conceptual and biochemical aspects. From viewing a tumor as a 'simple' aggregate of mutant cells and focusing on detecting key cell changes leading to the tumorigenesis, the understanding of cancer has broadened to consider it as a complex organ interacting with its close and far surroundings through tumor and non-tumor cells, metabolic mechanisms, and immune processes. Metabolism and the immune system have been linked to tumorigenesis and malignancy progression along with cancer-specific genetic mutations. However, most technologies developed to overcome the barriers to earlier detection are focused solely on genetic information. The concept of cancer as a complex organ has led to research on other analytical techniques, with the quest of finding a more sensitive and cost-effective comprehensive approach. Furthermore, artificial intelligence has gained broader consensus in the oncology community as a powerful tool with the potential to revolutionize cancer diagnosis for physicians. We herein explore the relevance of the concept of cancer as a complex organ interacting with the bodily surroundings, and focus on promising emerging technologies seeking to diagnose cancer earlier, such as liquid biopsies. We highlight the importance of a comprehensive approach to encompass all the tumor and non-tumor derived information salient to earlier cancer detection.© 2023. Italian National Cancer Institute ‘Regina Elena’.