A Systematic Review: Cell-Free DNA/Circulating Tumor DNA as an Outstanding Tumor marker in Ovarian Carcinoma

Introduction Ovarian cancer (OC) still is a deadly disease that Most women diagnosed with OC have advanced tumor stages/grades, which means they have a poor prognosis. CfDNA/CtDNA can have the same genetic and epigenetic alterations as tumors, including point mutations and promoter methylation. Because of these characteristics, cfDNA/ctDNA is a potential biomarker. This review study aimed to investigate the role of diagnostic cfDNA/ctDNA in OC. Methods This review was conducted using keywords such as circulating cell-free DNA, circulating tumor DNA, liquid biopsy, predictive biomarkers, diagnosis, and ovarian cancer in PubMed, Scopus, Medline, Science Direct, and Web of Science based on Cochrane Highly Sensitive Search Strategy. Results Of ۳۸ studies, the role of cfDNA/ctDNA was conducted in many methylations such as hMLH۱, BRCA۱ and RASSF۱A methylation, RASSFA methylation, OPCML methylation, DNA methylation, and ESR۱ methylation. On the other hand, they showed significant performances in some target mutations, including TP۵۳, PIK۳CA, KRAS, BRCA۱/۲ germline. Studies revealed that methylation of RASSF۱A and BRCA۱ was present in various stages and grades of ovarian cancer, suggesting that methylation of these genes may be used as a predictive marker in ovarian cancer patients. Moreover, studies showed that ERS۱ methylation was in primary tumors and paired circulating tumor DNA in high-grade serous ovarian cancer patients. Conclusion This systematic review showed that cfDNA/ctDNA could be used as a novel tumor marker to diagnose and monitor OC, therapeutic effects, and the chemotherapeutic response of OC. However, the value of cfDNA/ctDNA still needs to be explored continually.

Keywords:

Ovarian cancer , Cell-free DNA (cfDNA) , Circulating tumor DNA (ctDNA) , Diagnosis , Prognosis