Gliomas are diffusely growing tumours arising from progenitors within the central nervous system. They encompass a range of different molecular types and subtypes, many of which have a well-defined profile of driver mutations, copy number changes, and DNA methylation patterns. A majority of gliomas will require surgical intervention to relieve raised intracranial pressure and reduce tumour burden. A proportion of tumours, however, are located in neurologically sensitive areas and a biopsy poses a significant risk of a deficit. A majority of gliomas recur after surgery, and monitoring tumour burden of the recurrence is currently achieved by imaging. However, most imaging modalities have limitations in assessing tumour burden and infiltration into adjacent brain, and sometimes imaging is unable to discriminate between tumour recurrence and pseudo-progression. Liquid biopsies, obtained from body fluids such as cerebrospinal fluid or blood, contain circulating nucleic acids or extracellular vesicles containing tumour-derived components. The studies for this systematic review were selected according to PRISMA criteria, and suggest that the detection of circulating tumour-derived nucleic acids holds great promises as biomarker to aid diagnosis and prognostication by monitoring tumour progression, and thus can be considered a pathway towards personalized medicine.

中文翻译：

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是时候关注用于诊断和监测胶质瘤的循环核酸了：系统评价它们作为生物标志物的作用

胶质瘤是由中枢神经系统内的祖细胞产生的弥漫性生长肿瘤。它们包含一系列不同的分子类型和亚型，其中许多具有明确定义的驱动突变、拷贝数变化和 DNA 甲基化模式。大多数神经胶质瘤需要手术干预以缓解颅内压升高并减轻肿瘤负担。然而，一部分肿瘤位于神经敏感区域，活检具有明显的缺陷风险。大多数神经胶质瘤在手术后复发，目前通过成像来监测复发的肿瘤负荷。然而，大多数成像方式在评估肿瘤负荷和对邻近大脑的浸润方面存在局限性，有时影像学无法区分肿瘤复发和假性进展。从脑脊液或血液等体液中获得的液体活检含有循环核酸或含有肿瘤衍生成分的细胞外囊泡。本系统评价的研究是根据 PRISMA 标准选择的，表明循环肿瘤衍生核酸的检测作为生物标志物具有很大的前景，可通过监测肿瘤进展来帮助诊断和预后，因此可被视为通往个性化医疗的途径.