Progress of Liquid Biopsy in the Diagnosis and Treatment of Lung Cancer with Malignant Pleural Effusion

Abstract

肺癌是全球范围内死亡率最高的恶性肿瘤。晚期肺癌所致的恶性胸腔积液（malignant pleural effusion, MPE）严重影响患者的生活质量和预后。针对肿瘤的基因检测是制定精准治疗决策的基础，而组织活检取材存在风险，难以反复多次取样。液体活检由于具有无创性和可以反映肿瘤基因全貌的特点，在肺癌诊疗中的应用日益增多。基于血液样本的液体活检由于循环肿瘤DNA的含量极低，灵敏度和特异度有限。MPE中富含肿瘤细胞，检测其中的细胞游离DNA、细胞外囊泡和微小RNA等将有助于肺癌的诊断、治疗及预后的评估。本综述将探讨胸腔积液作为活检样本的研究，阐述液体活检在肺癌伴MPE诊疗中的研究进展。

Lung cancer is the malignancy with the highest mortality rate worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer severely affects the quality of life and prognosis of patients. Tumor-associated genetic testing is the basis for making precise treatment decisions. There are some risks of tissue biopsy, and it is difficult to sample repeatedly. Due to its non-invasive and can reflect the full profile of tumor gene characteristics, liquid biopsy is increasingly used in the diagnosis and treatment of lung cancer. Because of the extremely low DNA level of circulating tumor, the sensitivity and specificity of liquid biopsy based on blood samples are limited. Tumor cells is enriched in MPE. The detection of cell-free DNA, extracellular vesicles and microRNA in MPE will be helpful to the diagnose, treatment and assess prognosis of patients with lung cancer. This review aims to discuss the research progress of liquid biopsy based on MPE in the diagnosis and treatment of lung cancer patients.