Circulating nucleic acids as a tumor marker

Patients suffering from malignant diseases have been shown to have increased amounts of cell free nucleic acids in their circulation. As genetic and epigenetic alterations are increasingly characterized in different types of tumors, such changes can be used to detect tumor-derived nucleic acids in the circulation. To date, nearly all tumor-associated nucleic acids have been detected in the plasma or serum of cancer patients. Moreover, increased levels of circulating viral nucleic acids have also been demonstrated in patients with certain cancers associated with viral infections. The concentration of these tumor-associated nucleic acid species is generally related to the tumor load and the extent of the disease. Serial monitoring of plasma nucleic acids thus provides a good way to follow disease progress and to predict the outcome of such patients. In this review, different approaches of detecting tumor-related nucleic acids in the circulation and their potential as tumor markers in the screening, monitoring and prognostication of malignant diseases are discussed.