循环肿瘤 DNA 与肿瘤精准治疗

摘要

目前治疗肿瘤的手段多种多样，已经不完全局限于传统的手术切除及放化疗等，分子靶向治疗药物的普及使“精准医学”正逐步被应用到临床肿瘤领域。随着基因组学及生物大分子技术的日渐成熟，肿瘤精准医学将个体疾病的遗传学信息、诊断、治疗三者结合，使肿瘤的诊治更具有针对性、靶向性和特异性。因此，找到一种可以实时监测肿瘤状态的标志物至关重要。循环肿瘤DNA（ circulating tumour DNA，ctDNA）是肿瘤细胞在坏死、凋亡后释放的一种游离DNA，由于其在血液中循环，所以对ctDNA的检测可以及时反映肿瘤状态。目前ctDNA检测已应用于肿瘤的早期诊断、靶向治疗和预后判断等方面，由于高度特异性及灵敏性的新技术不断出现，检测ctDNA可作为一种“液体活检”，具有很好的临床应用前景。%[Abstratc] Up to now, there is a variety of treatments for tumor in addition to traditional surgical resection,radiotherapy and chemotherapy.The precision medicine based upon molecular targeted-therapy drugs has been gradually applied in clinical oncology. With gradually mature of genomics and biological macromolecules technology,tumor precision medicine that combines genetic informa-tion,diagnosis and treatment in individual disease makes tumor diagnosis and treatment more pertinent ,targeted,and specific.There-fore,it is of crucial importance to find a marker which monitors the state of tumor in real time.Circulating tumor DNA (ctDNA),a kind of cell-free DNA,is released after tumor cell necrosis or apoptosis.Since they circulate,detection of ctDNA may timely reflect the state of tumor.Currently ctDNA detection has been applied in early diagnosis,targeted therapy and prognosis of tumors.Due to the new tech-nology with high specificity and sensitivity are emerging,detecting ctDNA,as a kind of “liquid biopsy”,has great clinical application prospects.