文章：

循环肿瘤DNA（ctDNA）在胃食管腺癌（GEA）中的应用：证据与新兴前景

Circulating Tumor DNA (ctDNA) in Gastroesophageal Adenocarcinoma (GEA): Evidence and Emerging Applications

原文发布日期：18 November 2025

DOI: 10.3390/cancers17223692

类型: Article

开放获取: 是

英文摘要：

The role of circulating tumor DNA (ctDNA) in gastroesophageal adenocarcinoma (GEA) has expanded in recent years. In resectable disease, postoperative ctDNA is able to detect patients at highest risk of recurrence months before scans. Tumor-informed assays provide the best sensitivity and emerging methylation assays are useful when tissue is scarce. In metastatic GEA, baseline ctDNA burden correlates with prognosis, and a decrease in ctDNA level after treatment initiation reflects therapeutic response. It can also uncover actionable targets, includingERBB2,FGFR2, and MSI-H, and detect resistance that can arise after starting treatment. Limitations include variable assay performance, low shedding in some tumors, clonal hematopoiesis confounding, and a lack of randomized data showing that ctDNA-guided changes improve outcomes. Ongoing trials are testing MRD-guided escalation/de-escalation and ctDNA-directed biomarker therapy. In this review, we evaluate the role of ctDNA in GEA cancers over recent years.

摘要翻译： 

近年来，循环肿瘤DNA（ctDNA）在胃食管腺癌（GEA）中的作用日益扩大。在可切除疾病中，术后ctDNA能够在影像学检查前数月识别出复发风险最高的患者。肿瘤知情检测具有最佳灵敏度，而新兴的甲基化检测在组织样本稀缺时具有应用价值。在转移性GEA中，基线ctDNA负荷与预后相关，治疗启动后ctDNA水平的下降反映了治疗反应。ctDNA还能发现可干预的治疗靶点，包括ERBB2、FGFR2和MSI-H，并检测治疗开始后可能出现的耐药性。其局限性包括检测性能存在差异、部分肿瘤脱落水平较低、克隆性造血干扰，以及缺乏随机数据证明ctDNA指导的治疗调整能改善预后。目前正在进行的试验正在测试基于微小残留病灶（MRD）的强化/降级治疗策略和ctDNA指导的生物标志物治疗。本文综述了近年来ctDNA在GEA癌症中的作用。

原文链接：

Circulating Tumor DNA (ctDNA) in Gastroesophageal Adenocarcinoma (GEA): Evidence and Emerging Applications