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Review
. 2025 Mar 21;31(11):104170.
doi: 10.3748/wjg.v31.i11.104170.

Cholangiocarcinoma: The era of liquid biopsy

Evgenia Kotsifa  1 , Francesca Saffioti  2   3   4 , Vasileios K Mavroeidis  5   6   7
Affiliations
Review

Cholangiocarcinoma: The era of liquid biopsy

Evgenia Kotsifa et al. World J Gastroenterol. .

Abstract

Cholangiocarcinoma (CCA) is a highly aggressive and heterogeneous malignancy arising from the epithelial cells of the biliary tract. The limitations of the current methods in the diagnosis of CCA highlight the urgent need for new, accurate tools for early cancer detection, better prognostication and patient monitoring. Liquid biopsy (LB) is a modern and non-invasive technique comprising a diverse group of methodologies aiming to detect tumour biomarkers from body fluids. These biomarkers include circulating tumour cells, cell-free DNA, circulating tumour DNA, RNA and extracellular vesicles. The aim of this review is to explore the current and potential future applications of LB in CCA management, with a focus on diagnosis, prognostication and monitoring. We examine both its significant potential and the inevitable limitations associated with this technology. We conclude that LB holds considerable promise, but further research is necessary to fully integrate it into precision oncology for CCA.

Keywords: Biliary tract cancer; Biomarkers; Cell free DNA; Cholangiocarcinoma; Circulating RNA; Circulating tumour DNA; Circulating tumour cells; Extracellular vesicles; Precision medicine.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
The spectrum of liquid biopsy in cholangiocarcinoma: Types, biomarkers and applications. PCR: Polymerase chain reaction; NGS: Next-generation sequencing; CTCs: Circulating tumour cells; cfDNA: Cell-free DNA; ctDNA: Circulating tumour DNA; EVs: Extracellular vesicles; IDH: Isocitrate dehydrogenase; FGFR2: Fibroblast growth factor receptor 2.
Figure 2
Figure 2
Key findings of major studies on liquid biopsy in cholangiocarcinoma. CCA: Cholangiocarcinoma; CDO1: Cysteine dioxygenase type 1; CNRIP1: Cannabinoid receptor interacting protein 1; SEPT9: Septin 9; VIM: Vimentin; AUC: Area under the curve; Sens: Sensitivity; Sp: Specificity; PSC: Primary sclerosing cholangitis; NGS: Next generation sequencing; CTC: Circulating tumour cells; cfDNA: Cell-free DNA; CI: Confidence interval; HR: Hazard ratio; ctDNA: Circulating tumour DNA; DFS: Disease-free survival.
See this image and copyright information in PMC

References

    1. Razumilava N, Gores GJ. Cholangiocarcinoma. Lancet. 2014;383:2168–2179. - PMC - PubMed
    1. Banales JM, Marin JJG, Lamarca A, Rodrigues PM, Khan SA, Roberts LR, Cardinale V, Carpino G, Andersen JB, Braconi C, Calvisi DF, Perugorria MJ, Fabris L, Boulter L, Macias RIR, Gaudio E, Alvaro D, Gradilone SA, Strazzabosco M, Marzioni M, Coulouarn C, Fouassier L, Raggi C, Invernizzi P, Mertens JC, Moncsek A, Ilyas SI, Heimbach J, Koerkamp BG, Bruix J, Forner A, Bridgewater J, Valle JW, Gores GJ. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557–588. - PMC - PubMed
    1. Borakati A, Froghi F, Bhogal RH, Mavroeidis VK. Stereotactic radiotherapy for intrahepatic cholangiocarcinoma. World J Gastrointest Oncol. 2022;14:1478–1489. - PMC - PubMed
    1. Borakati A, Froghi F, Bhogal RH, Mavroeidis VK. Liver transplantation in the management of cholangiocarcinoma: Evolution and contemporary advances. World J Gastroenterol. 2023;29:1969–1981. - PMC - PubMed
    1. Khan SA, Tavolari S, Brandi G. Cholangiocarcinoma: Epidemiology and risk factors. Liver Int. 2019;39 Suppl 1:19–31. - PubMed

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