Gastrointestinal (GI) cancers, particularly colorectal and gastric cancers, majorly contribute to global cancer mortality due to frequent late-stage diagnosis and poor therapeutic response in advanced disease. Earlier detection of GI cancers is needed for a better prognosis. This review examines both traditional and emerging biomarkers that contribute significantly to early detection, prognostication, and prediction of therapeutic resistance or sensitivity. Specifically, we highlight the diagnostic utility of non-invasive liquid biopsy biomarkers such as circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomes. Moreover, we discuss the prognostic and predictive value of conventional genetic alterations, including KRAS, BRAF, and HER2. Although new findings have shown the advantages of liquid biopsy over colonoscopy, there are still limitations to the technique, such as cost-effectiveness, technological gaps in low-resource settings, and uncertain detection rates. Further studies are required to test the validity and accessibility of liquid biopsy and its biomarkers in order to advance personalized diagnosis and treatments for GI cancers. Such a study will be helpful for clinicians to better manage patients with GI cancers.
胃肠道癌症，尤其是结直肠癌和胃癌，由于晚期诊断频繁且进展期疾病治疗反应不佳，已成为全球癌症死亡的主要原因。改善预后需要更早发现胃肠道癌症。本综述探讨了在早期检测、预后评估以及治疗耐药性或敏感性预测方面具有重要价值的传统与新兴生物标志物。特别强调了循环肿瘤DNA（ctDNA）、微小RNA（miRNAs）和外泌体等无创液体活检生物标志物的诊断效用。此外，我们还讨论了包括KRAS、BRAF和HER2在内的传统基因改变的预后和预测价值。尽管新发现显示液体活检相较于结肠镜检查具有优势，但该技术仍存在局限性，如成本效益、资源匮乏环境下的技术差距以及不确定的检出率。需要进一步研究验证液体活检及其生物标志物的有效性和可及性，以推动胃肠道癌症的个性化诊断和治疗。此类研究将有助于临床医生更好地管理胃肠道癌症患者。
Beyond Detection: Conventional and Emerging Biomarkers in Gastrointestinal Cancers
肿瘤(癌症)患者之家