Internal medicine

Pathology

Fetus

Microvesicles

Circulating tumor cell

Biology

Gene

Operating system

Cancer

Aptamer

microRNA

Cell-free fetal DNA

Molecular biology

Standardization

Cancer biomarkers

Nucleic acid

Biopsy

Metastasis

Prenatal diagnosis

Pregnancy

Liquid biopsy

Computer science

Digital polymerase chain reaction

Computational biology

Biomarker

Polymerase chain reaction

Genetics

Medicine

Acta Cytologica

Liquid biopsy provides the opportunity of detecting, analyzing and monitoring cancer in various body effluents such as blood or urine instead of a fragment of cancer tissue. It is composed of different biological matrices such as circulating tumor cells (CTCs), cell free nucleic acids, exosomes or tumors “educated platelets.” In addition to representing a non- or minimally invasive procedure, it should represent a better view of tumor heterogeneity and allows for real-time monitoring of cancer evolution. Recent technological and molecular advances, greatly facilitated by the use of microfluidics in many cases, have permitted large progresses both in our ability to purify and analyze liquid biopsy components. In particular, the great developments of droplet-based digital PCR and the various optimizations of next generation sequencing technologies are central to the several validations of CTC-free DNA as a strong cancer biomarker. However, complete adoption of liquid biopsy in clinics will require pursuing recent efforts in the standardization of procedures both on the pre-analytical and analytical aspects.

Liquid Biopsy: General Concepts