液体活检在早期癌症检测中的技术革新与临床困境
Liquid biopsy for early cancer detection: technological revolutions and clinical dilemma
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影响因子:3.6
分区:医学3区 / 病理学3区
发表日期:2024 Oct
作者:
Sidney W Fu, Cong Tang, Xiaohui Tan, Sudhir Srivastava
DOI:
10.1080/14737159.2024.2408744
摘要
液体活检是肿瘤学中的一项创新进展，提供一种无创的早期癌症检测和监测方法，通过分析血液中的循环肿瘤细胞、DNA、RNA及其他生物标志物。这一技术有望通过提供肿瘤动态的实时分析，推动精准肿瘤学的发展，实现早期检测、监测治疗反应及根据个体分子特征定制个性化治疗。在本文中，作者讨论了液体活检的现有方法、技术挑战及临床应用，包括微量残留病变的检测、肿瘤演化追踪以及与其他诊断手段的结合。重点关注其灵敏度、特异性，以及多组学、人工智能（AI）、机器学习（ML）和大型语言模型（LLM）技术的整合。液体活检具有通过早期发现和个性化治疗策略革新癌症护理的巨大潜力，但其成功依赖于克服技术和临床难题，如确保高灵敏度和特异性、解读肿瘤异质性中的结果以及实现检测的可及性和经济性。持续的创新与合作是充分发挥液体活检在改善早期癌症检测、治疗和监测方面潜力的关键。
Abstract
Liquid biopsy is an innovative advancement in oncology, offering a noninvasive method for early cancer detection and monitoring by analyzing circulating tumor cells, DNA, RNA, and other biomarkers in bodily fluids. This technique has the potential to revolutionize precision oncology by providing real-time analysis of tumor dynamics, enabling early detection, monitoring treatment responses, and tailoring personalized therapies based on the molecular profiles of individual patients.In this review, the authors discuss current methodologies, technological challenges, and clinical applications of liquid biopsy. This includes advancements in detecting minimal residual disease, tracking tumor evolution, and combining liquid biopsy with other diagnostic modalities for precision oncology. Key areas explored are the sensitivity, specificity, and integration of multi-omics, AI, ML, and LLM technologies.Liquid biopsy holds great potential to revolutionize cancer care through early detection and personalized treatment strategies. However, its success depends on overcoming technological and clinical hurdles, such as ensuring high sensitivity and specificity, interpreting results amidst tumor heterogeneity, and making tests accessible and affordable. Continued innovation and collaboration are crucial to fully realize the potential of liquid biopsy in improving early cancer detection, treatment, and monitoring.