肿瘤内部异质性和“实时液体活检”研究进展

摘要

The heterogeneity of malignant tumor has been widely studied recently. Personalized treatment is well rec-ognized as a key to solve the problem. However,except the heterogeneity between cancer patients,the so called intra-tumor heterogeneity exists. It is documented that the genetic status and biological properties could change along with the tumor progression. Therefore,the efficiency of treatment strategy based on the test of tumor tissue obtained from bi-opsy or surgery is challenged. With the progression of the researches focusing on circulating tumor cells and circulating tumor DNAs,a new concept called " real - time liquid biopsy" has been put forward recently as a potential way to i-dentify and overcome the intratumor heterogeneity. Here,the potential mechanism of intratumor heterogeneity and the new concept are reviewed.%恶性肿瘤的异质性问题近年来受到广泛重视，个体化治疗作为对抗肿瘤异质性的一种临床策略已经获得高度认可。然而恶性肿瘤的异质性除了常见的病人之间的病灶状态差异外，还存在着一种内部异质性。已有研究提示进展后病灶或是转移灶可能较原发灶而言有着不同的基因状态与生物学特性，于是基于患者确诊时的活检或是手术切除组织拟定进展后的治疗策略开始受到质疑。循环肿瘤细胞和外周血游离 DNA 研究的不断深入，为解决上述问题提供了一种新的思路-“实时液体活检”。本文将对肿瘤内部异质性的成因和“实时液体活检”这一新的理念进行综述。