DOI: 10.26650/experimed.1940806 ISSN: 2667-5846

Refining Liquid Biopsy in ccRCC: CAIX as an Emerging Candidate Tool for CTC Detection

Özen Güler, Elif Ercan, Tuğba Uysal
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Several diagnostic, prognostic, and predictive biomarkers have been investigated in renal cell carcinoma (RCC), among which carbonic anhydrase IX (CAIX) is particularly relevant. Although CAIX is expressed in several RCC subtypes, its expression is particularly high in clear cell RCC (ccRCC), the most common RCC subtype and one with substantial metastatic potential. Given the tendency of ccRCC to form tumor emboli and disseminate, circulating tumor cells (CTCs) may serve as valuable prognostic and predictive markers. This review explores the potential of CAIX as a biomarker for CTC detection in ccRCC. Conventional CTC detection relies on epithelial markers, but these are often unreliable in ccRCC due to epithelial-mesenchymal transition (EMT). Alternative biomarker strategies, including CAIX-containing detection approaches, have shown promising preliminary performance and may help to address EMT-associated marker loss. However, their clinical utility requires validation in large prospective cohorts. Given the rarity and heterogeneity of CTCs, CAIX-containing enrichment strategies may contribute to prognostic assessment and longitudinal disease monitoring in patients with ccRCC. Additionally, this approach may provide deeper insights into tumor biology, potentially supporting more individualized treatment-monitoring strategies.

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