Introduction: Liquid biopsies provide a less-invasive option to tissue biopsies for the early diagnosis, prognosis, and tailored therapy of colorectal cancer (CRC). CRC is a major cause of cancer-related death, and early identification is essential for improving patient outcomes. Review: Conventional diagnostic techniques, including colonoscopy and tissue biopsy, may be enhanced by liquid biopsies that examine circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), extracellular vesicles (EVs), and other indicators present in body fluids. These markers provide significant insights into tumor biology, heterogeneity, and therapeutic response. CTCs detected in early-stage CRC have prognostic significance for disease recurrence and survival, while ctDNA investigation may uncover genetic mutations, epigenetic alterations, and tumor development. The identification of ctDNA in minimal residual disease (MRD) postsurgery correlates with an elevated risk of recurrence and unfavorable prognosis, underscoring its use in assessing treatment effectiveness. Furthermore, non-coding RNAs (ncRNAs) contained inside EVs provide potential prospective biomarkers and therapeutic targets, facilitating diagnosis and treatment assessment. Notwithstanding the potential of liquid biopsies, obstacles persist in assay standardization, sensitivity enhancement, and the management of tumor heterogeneity. Additional extensive research is required to determine their function in clinical practice. Conclusion: Overall, liquid biopsies serve as a potential instrument for real-time monitoring, evaluating therapy responses, and directing individualized therapeutic strategies in CRC patients.
引言：液体活检为结直肠癌的早期诊断、预后评估及个体化治疗提供了比组织活检创伤更小的选择。结直肠癌是癌症相关死亡的主要原因，早期识别对改善患者预后至关重要。综述：通过检测体液中的循环肿瘤细胞、循环肿瘤DNA、细胞外囊泡及其他生物标志物，液体活检可对结肠镜检和组织活检等传统诊断技术形成有效补充。这些标志物为肿瘤生物学特性、异质性及治疗反应提供了重要信息。早期结直肠癌中检测到的循环肿瘤细胞对疾病复发和生存预后具有重要价值，而循环肿瘤DNA分析可揭示基因突变、表观遗传改变及肿瘤进展。术后微小残留病灶中循环肿瘤DNA的检出与复发风险升高及不良预后相关，凸显了其在疗效评估中的应用价值。此外，细胞外囊泡内包含的非编码RNA可作为潜在的前瞻性生物标志物和治疗靶点，有助于诊断与治疗评估。尽管液体活检前景广阔，但在检测标准化、灵敏度提升及肿瘤异质性管理方面仍存在挑战。需要开展更广泛的研究以明确其在临床实践中的作用。结论：总体而言，液体活检可作为实时监测、评估治疗反应及指导结直肠癌患者个体化治疗策略的潜在工具。
Liquid Biopsies in the Early Diagnosis, Prognosis, and Tailored Treatment of Colorectal Cancer
肿瘤(癌症)患者之家