中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (10): 936-943.doi: 10.19401/j.cnki.1007-3639.2021.10.010

• 综述 • 上一篇    下一篇

非血液来源液体活检在胃癌早期诊断中的研究进展

徐亦天,黄 陈   

  1. 上海交通大学附属第一人民医院胃肠外科,上海 200080
  • 出版日期:2021-10-30 发布日期:2021-11-10
  • 通信作者: 黄 陈 E-mail: richard-hc@hotmail.com
  • 基金资助:
    国家自然科学基金(82072662、81772526);上海交通大学医学院高峰高原计划-“研究型医师”项目(20161425);上海交通大学医工交叉项目(YG2017MS28);上海促进市级医院临床技能与临床创新三年行动计划(SHDC2020CR4022);2021上海市“医苑新星”青年医学人才培养资助计划(杰出青年医学人才)。

Research advances in the early diagnosis of gastric cancer of non-blood derived liquid biopsy

XU Yitian, HUANG Chen   

  1. Department of Gastrointestinal Surgery, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China
  • Published:2021-10-30 Online:2021-11-10
  • Contact: HUANG Chen E-mail: richard-hc@hotmail.com

摘要: 胃癌是一种高度恶性的消化道肿瘤,早期胃癌若能及时接受手术治疗,治愈率可达90%,鉴于早期胃癌缺乏明显症状与敏感的肿瘤标志物,近80%的胃癌患者首次确诊时即处于进展期。液体活检作为一种新兴的分子检测技术,其无创、快速、经济、重复性好,具有比血清学肿瘤标志物更佳的敏感性与特异性,并能早于病理活检来诊断肿瘤,为胃癌的早期检测与风险评估带来了曙光。然而液体活检受限于诸多因素,始终未能在临床上广泛应用。其中一个主要原因是传统液体活检的绝大部分样本来自患者血液(包括血浆和血清),血液样本中低浓度的癌症衍生成分限制了液体活检在癌症发生或复发早期发现并预警的能力。最近的研究进一步扩展了液体活检的概念,发现来自血液以外体液的活检,即非血液来源液体活检,可以更好地筛查、诊断和监测肿瘤,有希望推进液体活检在胃癌早期诊断中的应用。我们通过检索近年来的相关文献,分析了非血液来源液体活检相比传统液体活检的优势与挑战,并对唾液、胃液、胃洗液和尿液四种体液来源的液体活检在胃癌早期诊断中的研究进展进行综述。

关键词: 液体活检, 胃癌, 早期诊断, 体液

Abstract: The cure rate of gastric cancer, a highly aggressive digestive tract malignancy, can reach more than 90%, if it can be treated by surgery at the early stage. However, due to the lack of obvious symptoms and sensitive tumor markers in the early stage of gastric cancer, nearly 80% of gastric cancer patients in China are in advanced stage when first diagnosed. As an emerging molecular detection technology, liquid biopsy is noninvasive, quick, economic and reproducible, and has better sensitivity and specificity than serological tumor markers. It can also detect tumor in advance of pathological biopsy, which brings a bright light for early detection and risk assessment of gastric cancer. Yet, liquid biopsy has not been widely used in clinic due to many factors. One of the main reasons is that most samples of traditional liquid biopsies are from patient’s blood (including plasma and serum), and the low concentration of cancer-derived components in the blood samples limits the ability of liquid biopsy to detect and warn occurrence or recurrence of early cancer. Recent research has further expanded the concept of liquid biopsies, finding that biopsies derived from fluids other than blood, called non-blood derived liquid biopsy, can better screen, diagnose and monitor tumors, promising to advance the use of liquid biopsies for the early diagnosis of gastric cancer. Therefore, by searching the relevant literature in recent years, we analyzed the advantages and challenges of non-blood derived liquid biopsy compared with traditional liquid biopsy, and reviewed the research advances of liquid biopsy derived from saliva, gastric juice, gastric wash and urine in gastric cancer.

Key words: Liquid biopsy, Gastric cancer, Early diagnosis, Body fluids