传统血清肿瘤标志物与循环肿瘤DNA在结直肠癌中的应用
Application of Traditional Serum Tumor Markers and Circulating Tumor DNA in Colorectal Cancer
DOI: 10.12677/acm.2026.1682960, PDF,    科研立项经费支持
作者: 肖坚伟, 唐 吉, 谭文华：承德医学院研究生学院，河北 承德；肖阿玲：厦门大学附属中山医院普外科，福建 厦门；高福洋*：承德市中心医院普外科，河北 承德
关键词: 结直肠肿瘤；肿瘤标志物；循环肿瘤DNA；Colorectal Cancer； Biomarkers Tumor； Circulating Tumor DNA
摘要: 结直肠癌(CRC)是全球发病率和死亡率均位居前列的恶性肿瘤，其疾病负担日益加重，对诊疗提出了更高要求。在结直肠癌的全程管理中，生物标志物发挥着不可或缺的作用，传统的血清肿瘤标志物：癌胚抗原(CEA)、糖类抗原19-9 (CA19-9)、糖类抗原24-2 (CA24-2)，因其检测便捷及经济性，在辅助诊断、疗效评估及复发监测中奠定了临床应用基础。然而，其灵敏度与特异度的局限性限制了其应用价值。循环肿瘤DNA(ctDNA)作为新兴的液体活检标志物，凭借其高度的肿瘤特异性，能够在分子水平上揭示肿瘤的基因特征，在微小残留病灶(MRD)检测、复发风险早期预警及疗效评估中展现出显著优势。本综述旨在系统探讨传统血清肿瘤标志物与ctDNA在结直肠癌诊疗中的发展与协同应用价值，分析二者的优势与局限性，为更精准有效的个体化监测提供参考。
Abstract: Colorectal cancer (CRC) is a malignancy with high global incidence and mortality rates. The increasing disease burden demands greater efficiency in diagnosis and treatment. Biomarkers play an indispensable role throughout the management of CRC. Traditional serum tumor biomarkers—Carcinoembryonic Antigen (CEA), Carbohydrate Antigen 19-9 (CA19-9), and Carbohydrate Antigen 24-2 (CA24-2)—are widely used in clinical practice for auxiliary diagnosis, efficacy evaluation, and recurrence monitoring due to their accessibility and cost-effectiveness. However, their limited sensitivity and specificity constrain their clinical utility. As an emerging liquid biopsy biomarker, circulating tumor DNA (ctDNA) offers high tumor specificity and enables molecular-level characterization of tumor genetics. It demonstrates considerable advantages in detecting minimal residual disease (MRD), providing early warning of recurrence risk, and assessing treatment response. This review systematically examines the evolving roles and synergistic potential of traditional serum biomarkers and ctDNA in the diagnosis and management of CRC, analyzing their respective strengths and limitations to inform more precise and effective individualized monitoring strategies.
文章引用：肖坚伟, 唐吉, 谭文华, 肖阿玲, 高福洋. 传统血清肿瘤标志物与循环肿瘤DNA在结直肠癌中的应用[J]. 临床医学进展, 2026, 16(8): 1769-1777. https://doi.org/10.12677/acm.2026.1682960

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