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液体活检革新肿瘤全程精准管理:现状与未来

Liquid Biopsy Revolutionizes the Precise Management of Tumors Across the Entire Course: Current Situation and Future Prospects

  • 摘要: 肿瘤是世界级公共卫生问题,导致了全球每年约六分之一的死亡。在诊断、治疗和监测的每个阶段实现对患者的精准化管理,既是当前临床实践中的一大挑战,也可作为提升患者生存率的重要策略。液体活检相较于传统检测具有创伤性小、可反复采样的优势。通过对患者身体易于重复获取的生物样本进行检测,液体活检能够在疾病诊断、治疗及预后随访全阶段提供信息,成为临床上实现对肿瘤微创、实时、全面监控的极具前景的组织样本替代方法。本文系统综述了肿瘤领域中常见的液体活检标志物及其最新检测技术,涵盖脑脊液、粪便等非血液样本的检测方案,并提出了基于“多标志物联合+全样本覆盖”的肿瘤全程精准管理新框架。文中也探讨了当前将液体活检发展为成熟临床检测项目所面临的一系列挑战,包括样本检测流程标准化、标准化报告制度的建立,以及如何平衡检测方法的普及性与成本控制等问题,以推动液体活检在肿瘤早筛、治疗革新与广泛应用方面的发展。我们期望通过构建从基础研究到转化生产、临床应用的全链条体系,开发一体化检测平台,建立标准化报告流程与完善监管机制,为患者提供从诊断到康复的全周期精准管理,最终使肿瘤从“不治之症”转变为“可防可控”的慢性疾病。

     

    Abstract: Tumors represent a global public-health concern, accounting for approximately one-sixth of all fatalities worldwide annually. Attaining precise management of patients across all stages of diagnosis, treatment, and surveillance is not merely a significant challenge in contemporary clinical practice but also a crucial strategy for enhancing patient survival rates. In comparison with traditional testing approaches, liquid biopsy offers the benefits of being less invasive and enabling repeated sampling. Through the examination of biological specimens that can be readily and repeatedly obtained from the patient's body, liquid biopsy can furnish information throughout the entire continuum of disease diagnosis, treatment, and follow-up prognosis. Consequently, it emerges as a highly prospective substitute for tissue samples in the minimally invasive, real-time, and comprehensive monitoring of tumors in clinical contexts. This article conducts a systematic review of the common liquid biopsy markers in the oncology field and their latest detection technologies. It encompasses detection schemes for non-blood samples such as cerebrospinal fluid and feces. Moreover, it proposes a novel framework for the precise management of the entire tumor process based on "multi-marker combination + full sample coverage". The article further deliberates on a series of challenges currently encountered in developing liquid biopsy into a mature clinical testing project. These challenges include the standardization of sample testing procedures, the establishment of standardized reporting systems, and how to strike a balance between the popularity of detection methods and cost control, with the aim of promoting the development of liquid biopsy in tumor early screening, treatment innovation, and extensive application. We anticipate constructing a full-chain system spanning from basic research to transformational production and clinical application. We aim to develop an integrated detection platform, establish standardized reporting procedures and a well-established regulatory mechanism, offer patients full-cycle precise management from diagnosis to rehabilitation, and ultimately convert cancer from an "incurable disease" into a "preventable and controllable" chronic disease.

     

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