近年来，结直肠癌（CRC）在诊疗方面取得长足进步，但目前标准治疗方案仍存在诸多不足，因此亟需更有效的生物标志物，用于患者的个性化治疗。循环肿瘤DNA（ctDNA）检测作为一种动态、非侵入性的液体活检方法，克服了组织活检在检测肿瘤异质性和分子演变中的不足。多项研究证据表明，ctDNA在复发风险分层、指导治疗决策和早期复发监测等方面展现出巨大前景。此外，ctDNA的应用还可提高临床研究的效率和药物开发。然而，ctDNA检测前变量和分析过程的标准化尚未统一，其技术成本也较高昂，这些均限制了其推广应用。本文总结了关于ctDNA在CRC临床管理中的现有证据，并提出了其局限性和改进策略。 Despite the great progress in the treatment of colorectal cancer (CRC), the current standard treatment protocols still have many limitations, and there is an urgent need for more effective biomarkers for personalized patient treatment. Circulating tumor DNA (ctDNA), as a dynamic, non-invasive liquid biopsy approach, overcomes the limitations of tissue biopsy in detecting tumor heterogeneity and molecular evolution. Current evidence from several studies suggests that ctDNA shows great promise in stratifying recurrence risk, guiding treatment decisions, and monitoring early recurrence. In addition, ctDNA can improve the efficiency of clinical research and drug development. However, the lack of standardisation of pre-ctDNA test variables and analysis procedures and the high technical costs limit its promotion and development. In this review, we summarize the available evidence on ctDNA in the clinical management of CRC and present its limitations and strategies for improvement.
Progress of circulating tumor DNA in the clinical management of colorectal cancer
Despite the great progress in the treatment of colorectal cancer (CRC), the current standard treatment protocols still have many limitations, and there is an urgent need for more effective biomarkers for personalized patient treatment. Circulating tumor DNA (ctDNA), as a dynamic, non-invasive liquid biopsy approach, overcomes the limitations of tissue biopsy in detecting tumor heterogeneity and molecular evolution. Current evidence from several studies suggests that ctDNA shows great promise in stratifying recurrence risk, guiding treatment decisions, and monitoring early recurrence. In addition, ctDNA can improve the efficiency of clinical research and drug development. However, the lack of standardisation of pre-ctDNA test variables and analysis procedures and the high technical costs limit its promotion and development. In this review, we summarize the available evidence on ctDNA in the clinical management of CRC and present its limitations and strategies for improvement.
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