ctDNA在妇科恶性肿瘤诊治中的研究进展

Research Progress of Circulating Tumor DNA in the Diagnosis and Treatment of Gynecological Malignant Tumors

摘要: 妇科中宫颈癌、卵巢癌和子宫内膜癌是女性生殖系统常见的恶性肿瘤，严重危害妇女健康。卵巢癌仍然是妇科恶性肿瘤中最致命的疾病，发病率逐年上升。对于这种恶性肿瘤来说提高早期诊断水平、争取治疗时机至关重要。我国妇科恶性肿瘤死亡率较高，主要的原因在于我国缺乏早期筛查、诊断方法，而当发现时多数患者已处于中晚期。目前在妇科恶性肿瘤早期检测和筛查、复发监测、治疗评估方面尚缺乏有效的检测手段。循环肿瘤DNA (circulating tumor DNA, ctDNA)是提供微创样本采集的主要液体活检方法。在许多类型的实体恶性肿瘤中都显示出诊断、预后和预测价值，最近的研究试图阐明它们在卵巢癌中的作用。本文对ctDNA的生物特性以及在妇科恶性肿瘤早期诊断与筛查、疗效评价、预测复发转移检测等方面进行综述。

Abstract: Cervical, ovarian and endometrial cancers are common malignant tumors of the female reproduc-tive system, which seriously endanger women’s health. Ovarian cancer remains the most lethal disease of gynecologic malignancies, and the incidence is increasing year by year. For this malignant tumor, it is important to improve the level of early diagnosis and strive for treatment time. The mortality rate of gynecological malignant tumors in China is relatively high, mainly due to the lack of early screening and diagnosis methods in China, and when it is found, most patients are in the middle and advanced stages. At present, there is a lack of effective detection methods for early de-tection and screening, recurrence monitoring, and treatment evaluation of gynecological malignant tumors. Circulating tumor DNA (ctDNA) is the primary liquid biopsy method that provides mini-mally invasive sample collection. They have shown diagnostic, prognostic, and predictive value in many types of solid malignancies, and recent studies have attempted to elucidate their role in ovarian cancer. This article introduces the biological characteristics of ctDNA and reviews its early diagnosis and screening of gynecological malignant tumors, efficacy evaluation, and prediction of recurrence and metastasis.