doi:10.3969/j.issn.1004-583X.2026.05.012

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对比维度	液体活检	组织活检
样本来源	血液、尿液等体液	肿瘤组织(需内镜或手术)
侵入性	微创(仅需抽血)	有创(需穿刺或手术)
动态监测可行性	可多次采样	不适合频繁操作
肿瘤异质性评估	可整合全身肿瘤克隆的异质性信息	仅能反映取样部位的肿瘤特征,存在漏检风险
术后监测适配性	术后无可见病灶时仍可完成MRD检测	术后无病灶时无法获取检测样本
临床核心场景	早筛、动态疗效监测、MRD复发预警、耐药追踪	初诊病理确诊、基线组织分子分型

对比维度	液体活检	组织活检
样本来源	血液、尿液等体液	肿瘤组织(需内镜或手术)
侵入性	微创(仅需抽血)	有创(需穿刺或手术)
动态监测可行性	可多次采样	不适合频繁操作
肿瘤异质性评估	可整合全身肿瘤克隆的异质性信息	仅能反映取样部位的肿瘤特征,存在漏检风险
术后监测适配性	术后无可见病灶时仍可完成MRD检测	术后无病灶时无法获取检测样本
临床核心场景	早筛、动态疗效监测、MRD复发预警、耐药追踪	初诊病理确诊、基线组织分子分型

体液类型	cfDNA浓度中位数 (μg/L)	主要来源细胞	胃癌临床应用优势
外周血	5~30	造血细胞、内皮细胞、肿瘤细胞	标准化采样流程、高富集度、动态监测可行性
腹腔积液	50~500	腹腔间皮细胞、胃癌腹膜转移灶细胞	肿瘤特异性信号富集,适配胃癌腹膜转移患者的检测与监测
胃灌洗液	10~40	胃黏膜上皮细胞、胃内肿瘤病灶细胞	直接富集病灶来源DNA,适配胃癌早期筛查与病灶定位

体液类型	cfDNA浓度中位数 (μg/L)	主要来源细胞	胃癌临床应用优势
外周血	5~30	造血细胞、内皮细胞、肿瘤细胞	标准化采样流程、高富集度、动态监测可行性
腹腔积液	50~500	腹腔间皮细胞、胃癌腹膜转移灶细胞	肿瘤特异性信号富集,适配胃癌腹膜转移患者的检测与监测
胃灌洗液	10~40	胃黏膜上皮细胞、胃内肿瘤病灶细胞	直接富集病灶来源DNA,适配胃癌早期筛查与病灶定位

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