Advances in the effects of circulating tumor DNA in lung cancer on the physiological and mechanical properties of lung tissue
Abstract
Lung cancer is one of the most common and lethal cancers in the world, and early diagnosis and precise treatment are crucial for improving patient survival. The physiological and mechanical properties of the lung tissue play a crucial role in the progression and diagnosis of lung cancer. Compared with traditional tissue biopsy, liquid biopsy technology provides a new perspective for lung cancer diagnosis and treatment monitoring. Circulating tumor DNA (ctDNA), as an important component of liquid biopsy, has attracted much attention due to its non-invasiveness and ability to dynamically reflect changes in the tumor genome. ctDNA is a fragment of DNA released by tumor cells into the bloodstream, carrying the genetic characteristics of the tumor cells, and may also be influenced by the mechanical microenvironment of the tumor tissue, which the mechanical stress and strain within the lung tissue due to breathing mechanics, as well as the mechanical forces exerted by the growing tumor mass, could potentially affect the release and fragmentation patterns of ctDNA. Therefore, ctDNA testing reflects tumor burden and genomic characteristics. In recent years, with the development of highly sensitive detection technologies, such as digital polymerase chain reaction (PCR) and high-throughput sequencing, research on the application of ctDNA in lung cancer has made significant progress. In lung cancer management, the application of ctDNA focuses on the following aspects: firstly, ctDNA can be used for early screening and diagnosis to help detect tiny tumor loads. Abnormal biomechanical changes in the lung may precede the appearance of detectable tumors, and analyzing ctDNA in relation to these mechanical alterations might help in detecting nascent tumor at an earlier stage. Second, during treatment, ctDNA can be used for dynamic monitoring of treatment response and detection of drug resistance mutations. Finally, ctDNA can also be used as a biomarker for prognostic assessment to help predict patient survival and risk of recurrence. Although the application of ctDNA in lung cancer shows great potential, its clinical application still faces some challenges, such as detection sensitivity, lack of standardised processes and complexity of bioinformatics analysis. Therefore, further research and clinical validation are necessary to promote the widespread use of ctDNA in lung cancer management. In this paper, we review the current status and prospects of circulating tumor DNA in lung cancer.
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