Gastroesophageal cancers including esophageal and gastric cancer remain major causes of global cancer mortality, primarily due to late diagnosis and high recurrence rates after curative treatment. Current surveillance methods, such as endoscopy and imaging, are invasive, costly, and often inadequate for detection. Blood-based biomarkers (“liquid biopsies”) offer a minimally invasive alternative capable of real-time tumor monitoring. In this review, we summarize recent advances across all major classes of blood-derived biomarkers: circulating tumor DNA (ctDNA), methylated DNA, cell-free RNAs (microRNAs, lncRNAs, circRNAs), circulating proteins, autoantibodies, circulating tumor cells, extracellular vesicles, and metabolites. Reviewing the existing literature on gastroesophageal cancers, we highlight current evidence, validation phases, performance metrics, and limitations. Special attention is given to clinical trial evidence, including ctDNA monitoring studies, that demonstrated earlier recurrence detection compared to imaging. While blood-based biomarker analysis has not yet supplanted endoscopy as standard of care in gastroesophageal cancer surveillance, the convergence of multi-analyte assays, AI, and clinical validation trials positions liquid biopsy as a transformative tool in the surveillance of gastroesophageal cancers.
胃食管癌（包括食管癌和胃癌）仍是全球癌症死亡的主要原因，这主要归因于诊断延迟及根治性治疗后高复发率。目前的内镜与影像学监测手段具有侵入性、成本高昂且常难以实现有效检测。基于血液的生物标志物（“液体活检”）作为一种微创替代方案，能够实现实时肿瘤监测。本文综述了血液来源生物标志物各主要类别的最新进展：循环肿瘤DNA（ctDNA）、甲基化DNA、游离RNA（microRNA、lncRNA、circRNA）、循环蛋白、自身抗体、循环肿瘤细胞、细胞外囊泡及代谢产物。通过梳理胃食管癌相关文献，我们重点阐述了现有证据、验证阶段、性能指标及局限性，特别关注临床试验证据（包括ctDNA监测研究），这些研究证明相较于影像学检查，液体活检能更早检测到复发。虽然基于血液的生物标志物分析尚未取代内镜成为胃食管癌监测的标准方案，但多组分检测、人工智能与临床验证试验的融合，正推动液体活检成为胃食管癌监测领域的变革性工具。
Blood-Based Surveillance Biomarkers for Gastroesophageal Cancers
肿瘤(癌症)患者之家