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Cell Free DNA Case Study

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Circulating tumor nucleic acids (ctNAs) composed of circulating tumor DNA (ctDNA), mRNA and microRNA that are released and circulate in the blood of cancer patient, and changes in the levels of ctNAs in the circulation have been associated with tumor burden, tumor stage, vascularity, cellular turnover, response to therapy and metastasis12, 210-212.
It has been postulated that cell free DNA (cfDNA) can originates directly from the viable tumor cells or from CTCs by apoptosis, necrosis, autophagy, micro-environmental stress, mitotic catastrophe, trauma and treatment procedure12, 213-220, others includes viruses, such as EBV, HPV and hepatitis B virus221-223. Cell free DNA (cfDNA) is regarded as ‘circulating tumor DNA’ (ctDNA) after …show more content…

Withal, not all cfDNA originates from cell death; viable cells also release cfDNA as a part of homeostasis215, 217, 246, 247. In addition to this, it has also been seen that incitements of lymphocytes can results into release of large numbers of cfDNA in the absence of apoptosis or necrosis216, 246, 248. Moreover, It has been suggested that cfDNA act as a ligand for Toll-like receptor 9 (TLR9) that may inhibit pro-apoptotic caspases by virtue of TLR9-dependent signaling249. This signifies a possible immunomodulatory role for cfDNA. These days cfDNA remains to be hot topic and is widely used for wide range of research and clinical purposes, including tumor genotyping, early cancer detection, patient prognosis, minimal residual disease monitoring, therapy evaluation, biomarker in transplant surgery for graft injury and prediction of allograft rejection53, 250-262 . Multiple studies have demonstrated that patients with invasive tumors such as lung, breast, pancreas, colon, hepatocellular, ovarian, prostate, esophageal and melanoma generally have high level of ctDNA in their plasma than in healthy individuals263-268. Several genomic studies of tumor mutations have analyzed ctDNA to quantify tumor burden and to detect therapeutic resistance conferring mutations211, 269-271. Moreover, a correlation has been set up

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