Abstract
Colorectal cancer (CRC) is one of the most common gastrointestinal tumors and the second leading cause of cancer death worldwide. Since traditional biopsies are invasive and do not reflect tumor heterogeneity or monitor the dynamic progression of tumors, there is an urgent need for new noninvasive methods that can supplement and improve the current management strategies of CRC. Blood-based liquid biopsies are a promising noninvasive biomarker that can detect disease early, assist in staging, monitor treatment responses, and predict relapse and metastasis. Over time, an increasing number of experiments have indicated the clinical utility of liquid biopsies in CRC. In this review, we mainly focus on the development of circulating tumor cells and circulating tumor DNA as key components of liquid biopsies in CRC and introduce the potential of exosomal microRNAs as emerging liquid biopsy markers in clinical application for CRC.
Highlights
Colorectal cancer (CRC) is one of the most common gastrointestinal tumors and the second leading cause of cancer death worldwide [1]
The results suggested that tumor tissue and circulating tumor cells (CTCs) had 70% identity in the KRAS mutation state, while the BRAF mutation was less consistent [104]
CTC assays are expected to supplement imaging methods for the diagnosis of disease recurrence. Another significant study of 84 colon cancer patients undergoing chemotherapy showed that changes in the number of CTCs reflected the objective efficacy of the tumor at an early stage, with a sensitivity of 64%, specificity of 70%, and positive predictive value of 74%
Summary
Colorectal cancer (CRC) is one of the most common gastrointestinal tumors and the second leading cause of cancer death worldwide [1]. Liquid biopsy is a general term originally introduced in the analysis of circulating tumor cells (CTCs) [5] that widely refers to the analysis of various biological fluids isolated from cancer patients, such as peripheral blood, urine, pleural effusion, ascites, and cerebrospinal fluid [6, 7]. Peripheral blood remains the main source of fluid biopsy, and its analytes mainly include CTCs, circulating tumor DNA (ctDNA), circulating tumor RNA (ctRNA), and exosomes (Figure 1) [8]. Analysis of these blood components can be used for early cancer detection, auxiliary staging, prognosis assessment, and monitoring drug resistance and minimal residual disease (MRD) [9], highlighting the potential of liquid biopsies (Figure 2).
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