检测根治性切除术后大肠癌最小残留病灶的潜在价值。

IF 7 2区 医学 Q1 ONCOLOGY
Wenji Pu, Fang Chen, Yuan Tang, Yanling Qu, Yunzhu Han, Jiandong Zha, Jing Jin, Fengming Kong
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引用次数: 0

摘要

尽管近年来在结直肠癌(CRC)的识别和管理方面取得了重大进展,但目前的标准治疗方案仍有改进的余地。其中一个值得关注的问题是缺乏可靠的肿瘤标志物来预测治疗效果和指导有针对性的治疗。与组织活检相比,基于循环肿瘤 DNA(ctDNA)的微小或分子残留病灶(MRD)检测具有动态、有效和无创的优点,有利于对根治性治疗后的 CRC 患者进行药物临床开发,也有利于对肿瘤复发和恶性肿瘤分子基因演变进行持续监测。根据大量的观察性或前瞻性临床研究,ctDNA 的检测目前可用于指导 CRC 患者的术后辅助治疗决策(升级或降级治疗),更精确地对临床复发风险进行分层,并在影像学检查前预测复发风险。随着ctDNA越来越清晰,根据术后ctDNA选择治疗方案的可能性也越来越大,这也提高了CRC临床复发风险评估的准确性。因此,可以预见,ctDNA 的鉴定将改变目前处理 CRC 的框架,并带来个体化、分层的精准治疗;不过,进一步的确认还需要后续的高质量、前瞻性、大规模随机对照研究。本文将概述 MRD 的定义和临床意义、MRD 检测的主要适应症和技术挑战,以及有关 CRC 根治性切除术后 ctDNA 检测的临床研究进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Potential value of detection of minimal residual disease in colorectal cancer following radical resection.

Although there has been significant advancement in the identification and management of colorectal cancer (CRC) in recent years, there is still room for improvement in the current standard treatment regimen. One area of concern is the lack of reliable tumor markers to predict treatment efficacy and guide tailored care. Due to its dynamic, effective, and non-invasive benefits over tissue biopsy, the detection of minimal or molecular residual lesions (MRD) based on circulating tumor DNA (ctDNA) is beneficial to the clinical development of drugs for patients with CRC after radical treatment, as well as for continuous monitoring of tumor recurrence and malignancy molecular gene evolution. The detection of ctDNA can currently be used to guide individual postoperative auxiliary treatment decisions (upgrade or downgrade treatment) in CRC, stratify the risk of clinical recurrence more precisely, and predict the risk of recurrence in advance of imaging examination, according to a large number of observational or prospective clinical studies. With increasing clarity comes the possibility of selecting a regimen of treatment based on postoperative ctDNA, which also improves the accuracy of clinical recurrence risk assessment for CRC. Therefore, it is anticipated that the identification of ctDNA would alter the current framework for dealing with CRC and lead to individualized, stratified precision therapy; however, additional confirmation will require subsequent high-quality, prospective, large-scale randomized controlled studies. This article will provide an overview of the definition and clinical significance of MRD, the primary indications and technological challenges for MRD detection, along with the advancement in clinical research about ctDNA detection following radical resection of the CRC.

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来源期刊
自引率
9.80%
发文量
1726
审稿时长
4.5 months
期刊介绍: Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.
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