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南京医科大学学报(自然科学版)                                 第43卷第11期
               ·1596 ·                    Journal of Nanjing Medical University(Natural Sciences)  2023年11月


             ·综 述·

              循环肿瘤DNA检测在胃肠间质瘤诊疗中的价值



              王盛锦,王 峰,孙          锋 *
              昆明医科大学第二附属医院胃肠外科,云南 昆明                   650101




             [摘    要] 胃肠间质瘤(gastrointestinal stromal tumor,GIST)起源于胃肠道间叶组织,多数继发于KIT及血小板源性生长因子受
              体α(platelet derived growth factor receptor alpha,PDGFRA)基因突变,这一发现对 GIST 的基础研究和临床诊疗具有里程碑意
              义。基因检测被广泛运用于明确GIST的病理诊断、判断预后及指导靶向药物治疗等诸多领域。近年来众多研究表明包括循
              环肿瘤DNA(circulating tumor DNA,ctDNA)检测在内的液体活检技术对GIST的诊疗有极其重要的临床价值和广阔的应用前
              景,本文主要论述ctDNA检测用于GIST诊疗的价值。
             [关键词] 胃肠间质瘤;液体活检;循环肿瘤DNA;诊断治疗
             [中图分类号] R735                    [文献标志码] A                        [文章编号] 1007⁃4368(2023)11⁃1596⁃09
              doi:10.7655/NYDXBNS20231119


              The value of circulating tumor DNA detection in the diagnosis and treatment of

              gastrointestinal stromal tumors
                                                 *
              WANG Shengjin,WANG Feng,SUN Feng
              Department of Gastroinetestinal Surgery,the Second Affiliated Hospital of Kunming Medical University,Kunming
              650101,China


             [Abstract] Gastrointestinal stromal tumors(GIST)originate from gastrointestinal mesenchymal tissues,and most of them are
              secondary to KIT and platelet derived growth factor receptor alpha(PDGFRA)gene mutations. This discovery has a landmark
              significance for the basic research,clinical diagnosis and treatment of GIST. Genetic testing is widely used in many fields,such as
              identifying pathological diagnosis of GIST,judging prognosis and guiding targeted drug therapy. In recent years,numerous studies have
              shown that liquid biopsy techniques,including circulating tumor DNA(ctDNA)detection,have shown extremely important clinical
              values and broad application prospects for the diagnosis and treatment of GIST. This article reviews the value of ctDNA detection in the
              diagnosis and treatment of GIST.
             [Key words] gastrointestinal stromal tumor;liquid biopsy;circulating tumor DNA;diagnoses and treatment
                                                                           [J Nanjing Med Univ,2023,43(11):1596⁃1604]




                  胃 肠 间 质 瘤(gastrointestinal stromal tumor,     derived growth factor receptor alpha,PDGFRA)基因获
              GIST)是消化道最常见的间叶源性肿瘤,不同国家                          得性突变 。GIST 基因检测技术包括一代基因测
                                                                         [3]
              和地区的发病率不同,全世界每10万人中6~22人患                         序、二代基因测序和液体活检              [4-5] 。液体活检是利用
              有GIST ,我国GIST的发病率为每10万人口42例,                      人体血液或体液作为标本来源获取肿瘤相关信息的
                    [1]
              老年人多见,男性发病率略高于女性 。其发病机                            技术,其检测标志物主要包括循环肿瘤细胞(circula⁃
                                               [2]
              制主要为 KIT、血小板源性生长因子受体α(platelet                    ting tumor cell,CTC)、循 环 肿 瘤 DNA(circulating
                                                                tumor DNA,ctDNA)、循环游离 DNA(circulating free
                                                                DNA,cfDNA)、循环 RNA(circulating RNA,cRNA)
             [基金项目] 院士专家工作站(202205AF150011);国家自然
              科学基金(81960508)                                    和细胞外囊泡(extracellular vesicle,EV)等不同分
              ∗                                                 子 [5-8] 。细胞外的DNA片段主要吸附在血液中的红
              通信作者(Corresponding author),E⁃mail:1346180395@qq.com
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