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Disadvantages Of Cell Free Dna

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It has been postulated that cell free DNA (cfDNA) can originate directly from the viable tumor cells or from CTCs by apoptosis, necrosis, autophagy, micro-environmental stress, mitotic catastrophe, trauma and treatment procedure [17, 218-225], others includes viruses, such as EBV, HPV and hepatitis B virus [226-228]. Moreover, cfDNA is regarded as ‘circulating tumor DNA’ (ctDNA) after mutations in cfDNA in cancer; hence, information regarding the origination and release of ctDNA may provide insight to clinicians about their possible roles and nature of disease. Of these, many studies have shown that ctDNA convey genomic and epigenomic modifications indistinguishable to those of tumor cells [229]. Studies have demonstrated that cfDNA is …show more content…

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 signaling [254]. This signifies a possible immunomodulatory role for cfDNA. These days cfDNA remains to be a hot topic and is widely used for a 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 rejection [58, 255-267] . In recent years, multiple studies have demonstrated that patients with invasive tumors such as lung, breast, pancreas, colon, hepatocellular, ovarian, prostate, esophageal and melanoma generally have a high level of ctDNA in their plasma than in healthy individuals [268-273]. Several genomic studies of tumor mutations have analyzed ctDNA to quantify the tumor burden and to detect therapeutic resistance conferring mutations [216, 274-276]. Moreover, a correlation has been set up between the levels of non-mutated cfDNA and mutated cfDNA in circulation and the tumor stage [277, 278]. In addition to this, some studies have also found that mutated cfDNA can lead to therapeutic resistance in cancer several months prior to detection of

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