Circulating tumor cells and DNA as liquid biopsies.

Circulating tumor cells and DNA as liquid biopsies.
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DOI:
10.1186/gm477
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发表时间:
2013
期刊:
影响因子:
12.3
通讯作者:
Speicher MR
Speicher MR
中科院分区:
生物学1区
文献类型:
--
作者:
Heitzer E;Auer M;Ulz P;Geigl JB;Speicher MR

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对于癌症患者,目前的预后方法依赖于临床病理分期,但通常这提供了关于个体对治疗的反应的信息很少。因此,存在对具有预测和预后信息的蛋白质和遗传生物标志物的巨大需求。随着生物标志物的鉴定,对肿瘤基因型的连续监测变得越来越可能,而肿瘤基因型在选择压力下是不稳定的并且容易发生变化。为此,从原发性和转移性癌症脱落的循环肿瘤细胞(CTC)或循环肿瘤DNA(ctDNA)可以允许通过“液体活检”在治疗和疾病进展期间对肿瘤基因组的演变进行非侵入性分析。在这里,我们回顾了在血液中成千上万的其他细胞中识别CTC的最新进展,以及新的高分辨率方法,包括最近的微流体平台,用于解剖CTC的基因组并获得功能数据。我们还讨论了新的ctDNA为基础的方法,这可能成为一个强大的替代CTC分析。总之,这些方法为转移过程提供了新的生物学见解,并可能阐明参与细胞侵袭性和转移能力的信号通路。在医学上,这些液体活检可能成为强大的预测和预后生物标志物,因此可能有助于精确或个性化医疗等领域。
For cancer patients, the current approach to prognosis relies on clinicopathological staging, but usually this provides little information about the individual response to treatment. Therefore, there is a tremendous need for protein and genetic biomarkers with predictive and prognostic information. As biomarkers are identified, the serial monitoring of tumor genotypes, which are instable and prone to changes under selection pressure, is becoming increasingly possible. To this end, circulating tumor cells (CTCs) or circulating tumor DNA (ctDNA) shed from primary and metastatic cancers may allow the non-invasive analysis of the evolution of tumor genomes during treatment and disease progression through 'liquid biopsies'. Here we review recent progress in the identification of CTCs among thousands of other cells in the blood and new high-resolution approaches, including recent microfluidic platforms, for dissecting the genomes of CTCs and obtaining functional data. We also discuss new ctDNA-based approaches, which may become a powerful alternative to CTC analysis. Together, these approaches provide novel biological insights into the process of metastasis and may elucidate signaling pathways involved in cell invasiveness and metastatic competence. In medicine these liquid biopsies may emerge to be powerful predictive and prognostic biomarkers and could therefore be instrumental for areas such as precision or personalized medicine.
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