Current advances and future prospects of blood-based techniques for identifying benign and malignant pulmonary nodules

Xin Wang; Yanmei Chen; Chengcheng Ma; Lingfeng Bi; Zhixi Su; Weimin Li; Zhoufeng Wang

doi:10.1016/j.critrevonc.2024.104608

Current advances and future prospects of blood-based techniques for identifying benign and malignant pulmonary nodules

Crit Rev Oncol Hematol. 2025 Jan 4:104608. doi: 10.1016/j.critrevonc.2024.104608. Online ahead of print.

Authors

Xin Wang¹, Yanmei Chen², Chengcheng Ma³, Lingfeng Bi¹, Zhixi Su³, Weimin Li⁴, Zhoufeng Wang⁵

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² Health Management Center, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan, China.
³ Singlera Genomics Ltd., Shanghai.
⁴ Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China; The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu, Sichuan, China.
⁵ Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: [email protected].

PMID: 39761937
DOI: 10.1016/j.critrevonc.2024.104608

Abstract

Lung cancer is the leading cause of cancer-related mortality worldwide, highlighting the urgent need for more accurate and minimally invasive diagnostic tools to improve early detection and patient outcomes. While low-dose computed tomography (LDCT) is effective for screening in high-risk individuals, its high false-positive rate necessitates more precise diagnostic strategies. Liquid biopsy, particularly ctDNA methylation analysis, represents a promising alternative for non-invasive classification of indeterminate pulmonary nodules (IPNs). This review highlights the progress and clinical potential of liquid biopsy technologies, including traditional proteins markers, cfDNA, exosomes, metabolomics, circulating tumor cells (CTCs) and platelets, in lung cancer diagnosis. We discuss the integration of ctDNA methylation analysis with traditional imaging and clinical data to enhance the early detection of IPNs, as well as potential solutions to address the challenges of low biomarker concentration and background noise. By advancing precision diagnostics, liquid biopsy technologies could transform lung cancer management, improve survival rates, and reduce the disease burden.

Keywords: DNA methylation; Early detection; Indeterminate pulmonary nodules; Liquid biopsy; Lung cancer.

Publication types

Review