New Diagnostic Methods and Liquid Biopsy in Gliomas

Mustafa Çağlar ŞAHİNa , Hakan EMMEZb

aKulu State Hospital, Clinic of Neurosurgery, Konya, Türkiye
bAnkara Güven Hospital, Clinic of Neurosurgery, Ankara, Türkiye

Şahin MÇ, Emmez H. New diagnostic meth- ods and liquid biopsy in gliomas. In: Uğur HÇ, Bayatlı E, eds. Glial Tumours: Expectations from Today-Promises of the Future. 1st ed. An- kara: Türkiye Klinikleri; 2024. p.18-23.

ABSTRACT

Gliomas represent the most frequently occurring primary malignant tumors within the central ner- vous system. Gliomas account for 30% of all primary brain tumors and 80% of malignant ones, making them the leading cause of mortality associated with primary brain tumors. Current methods used in the diagnosis and fol- low-up of glioma consist of both invasive and non-invasive tests. Research focuses on less invasive methods for diagnosing and monitoring glioma, aiming to decrease morbidity. Liquid biopsy, an analysis of cells and genetic materials from blood and body fluids, identifies tumor-related molecular characteristics. This method allows us to obtain important information such as tumor type, severity and response to treatment at the molecular level. As a minimally invasive method, liquid biopsy can better reflect tumor heterogeneity and offers the ability to con- tinuously monitor the dynamic nature of the tumor. However, it has disadvantages such as the inability to pro- vide histological diagnosis and staging, lack of standardization, and high costs. The processes of apoptosis and necrosis in cancer cells within the tumor microenvironment contribute to the release of nucleic acids into the bloodstream. Macrophages phagocytose dying cells and trigger DNA release. During this process, a significant portion of the DNA originating from the tumor may enter the blood on a daily basis. Liquid biopsy includes cir- culating tumor cells, circulating free DNA, circulating tumor DNA, extracellular microRNA, tumor-educated platelets, exosomes, and other extracellular non-coding RNAs. The capacity of liquid biopsy to examine tumor- derived materials in bodily fluids has expanded its application across various tumor types. This method offers real- time insights into tumor dynamics while delivering crucial diagnostic and prognostic data. In the case of gliomas, the use of liquid biopsy is highly promising. With the development of liquid biopsy techniques, its usage areas are also expanding. In addition to gliomas, liquid biopsy has become available for monitoring localized tumors, evaluating response to treatment, and even monitoring some benign diseases. This expanding range of applica- tions demonstrates how liquid biopsy can revolutionize oncology and other areas of medicine. The advances made in the field of liquid biopsy in recent years are opening new horizons in cancer research.

Keywords: Circulating neoplastic cells; exosomes; glioma; liquid biopsy; diagnosis

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