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Review Open Access

Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review)

  • Authors:
    • Bin Tian
    • Xuesong Chen
    • Jiang Zheng
    • Xin Kang
  • View Affiliations / Copyright

    Affiliations: Sports Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, P.R. China
    Copyright: © Tian et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 72
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    Published online on: February 12, 2026
       https://doi.org/10.3892/or.2026.9077
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Abstract

Liquid biopsy, which involves the detection of circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs), is revolutionizing the management of osteosarcoma, Ewing sarcoma and chondrosarcoma by enabling noninvasive diagnosis, risk stratification and real‑time treatment monitoring. ctDNA analysis allows for the sensitive detection of tumor‑specific alterations, whereas CTCs provide insights into metastatic potential. Baseline ctDNA burden independently predicts poor survival, while dynamic ctDNA kinetics and CTC counts guide neoadjuvant response assessment and postoperative minimal residual disease surveillance. Notably, the integration of liquid biopsy into adaptive clinical pathways can refine precision oncology for these rare, lethal bone malignancies.
View Figures

Figure 1

Biological foundations of ctDNA and
CTC release in primary bone tumors. This figure was created using
Figdraw (https://www.figdraw.com). ctDNA,
circulating tumor DNA; CTC, circulating tumor cell; DNASE1L3,
deoxyribonuclease 1-like 3; VEGFA, vascular endothelial growth
factor A.

Figure 2

Pre-analytical and analytical
workflow for ctDNA and CTCs in bone sarcoma liquid biopsy. This
figure was created using Figdraw (https://www.figdraw.com). AUC, area under the curve;
BCT, blood collection tubes; cfDNA, cell-free DNA; CK, cytokeratin;
ctDNA, circulating tumor DNA; CTC, circulating tumor cell; CV,
coefficient of variation; dPCR, digital PCR; ELBS, European Liquid
Biopsy Society; EpCAM, epithelial cell adhesion molecule; ISH,
in situ hybridization; LOD, limit of detection; NGS,
next-generation sequencing; RT, room temperature; SATB2, special
AT-rich sequence-binding protein 2; VAF, variant allele
frequency.
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Copy and paste a formatted citation
Spandidos Publications style
Tian B, Chen X, Zheng J and Kang X: Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review). Oncol Rep 55: 72, 2026.
APA
Tian, B., Chen, X., Zheng, J., & Kang, X. (2026). Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review). Oncology Reports, 55, 72. https://doi.org/10.3892/or.2026.9077
MLA
Tian, B., Chen, X., Zheng, J., Kang, X."Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review)". Oncology Reports 55.4 (2026): 72.
Chicago
Tian, B., Chen, X., Zheng, J., Kang, X."Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review)". Oncology Reports 55, no. 4 (2026): 72. https://doi.org/10.3892/or.2026.9077
Copy and paste a formatted citation
x
Spandidos Publications style
Tian B, Chen X, Zheng J and Kang X: Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review). Oncol Rep 55: 72, 2026.
APA
Tian, B., Chen, X., Zheng, J., & Kang, X. (2026). Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review). Oncology Reports, 55, 72. https://doi.org/10.3892/or.2026.9077
MLA
Tian, B., Chen, X., Zheng, J., Kang, X."Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review)". Oncology Reports 55.4 (2026): 72.
Chicago
Tian, B., Chen, X., Zheng, J., Kang, X."Liquid biopsy in malignant primary bone tumors: Clinical applications of circulating tumor DNA and circulating tumor cells for diagnosis, prognosis and treatment monitoring (Review)". Oncology Reports 55, no. 4 (2026): 72. https://doi.org/10.3892/or.2026.9077
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