Advancing Cancer Management: The Dual Diagnostic-Prognostic Potential of Nucleic Acid Biomarkers

Cancer is a global health issue with a high mortality rate, and early detection significantly improves patient survival rates. Currently, the primary methods for cancer detection include imaging examination and tissue biopsy. However, due to technical limitations, early detection can result in invasiveness, false positives, and other complications for patients. Therefore, there is an urgent need for new cancer biomarkers to address these challenges and enhance the accuracy and non-invasiveness of detection. With advances in molecular biology, nucleic acid biomarkers have become invaluable for early cancer diagnosis, prognosis assessment, and therapeutic monitoring. Epigenetic biomarkers, such as DNA methylation and non-coding RNA, play a crucial role in tumorigenesis by regulating related gene expression. However, although they offer significant potential for early warning, the complexity of the detection process coupled with tissue specificity makes the interpretation of results challenging. Liquid biopsy, such as circulating tumor DNA (ctDNA), provide a non-invasive method for dynamic tumor monitoring. However, its applicability is limited due to low sensitivity and high cost. Combining these two approaches can help address their individual shortcomings. CtDNA methylation enhances screening specificity, while multimodal strategies are expected to overcome the limitations of single techniques. The purpose of this review is to explore the role of cancer nucleic acid markers in cancer diagnosis and prognosis, examine their molecular mechanisms, and evaluate the advantages and limitations of these markers. Additionally, it will discuss biomarkers related to the tumor microenvironment and immune response, and their interactions with nucleic acids.