Liquid Biopsy and Circulating Biomarkers in Clinical Chemistry of Colorectal Cancer
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Colorectal cancer (CRC) is one of the most prevalent types of cancer worldwide and early detection and prompt therapeutic interventions are crucial for survival. While effective, traditional diagnostic tools like colonoscopes and tissue biopsies are invasive and are not always practical to use for ongoing surveillance. Liquid biopsy has become a promising minimally invasive method allowing to real-time assess tumor dynamics by analysing circulating biomarkers in recent years. Of these, circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes and microRNAs (miRNAs) have great promise in clinical chemistry applications. The analysis of ctDNA can detect tumor-specific mutations, microsatellite instability and minimal residual disease, which enhances the accuracy of diagnosis and enables personalized therapy. CTCs offer information on tumor heterogeneity, metastatic potential, and resistance to treatment, whereas exosomes and miRNAs are important mediators of cell-cell communication and can be used as stable biomarkers of disease progression. Several benefits of the routine use of liquid biopsy in CRC cases are its ability to detect recurrence, predict prognosis, to monitor therapeutic response and to provide early diagnosis. Moreover, improvements of analytical methods (e.g., digital PCR, next-generation sequencing) have increased the sensitivity and specificity of the detection of biomarkers in liquid biopsy, making it a valuable tool for precision oncology. Although there are issues of standardization, cost, and validation in large populations, liquid biopsy is a game-changing paradigm in the clinical care of colorectal cancer. Future studies should yield better panels of biomarkers and enhance their clinical utility, and increase the utility of liquid biopsy for personalized cancer treatment
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