Comparative analysis of intraoperative liquid biopsy in tumor margin detection during hepatobiliary and gastrointestinal cancer surgeries

Title

Comparative analysis of intraoperative liquid biopsy in tumor margin detection during hepatobiliary and gastrointestinal cancer surgeries

Authors

Mukul Singh^1,*, Parth Jani² & Reetika S.U Kashyap³

Affiliation

¹Department of General Surgery, All India Institute of Medical Sciences (AIIMS) Gorakhpur, Uttar Pradesh, India; ²Department of General Medicine, Government Medical College, Bhavnagar, India; ³Department of Family Medicine, Parkway Forest Medical Centre

#40-105 Parkway Forest Drive, North York, Ontario, Canada; *Corresponding author

Mukul Singh - E-mail: singhmukul3911@gmail.com

Parth Jani - E-mail: parthjani13@gmail.com

Reetika SU Kashyap – E-mail: kashyapreetika610@gmail.com

Article Type

Research Article

Date

Received July 1, 2026; Revised July 31, 2026; Accepted July 31, 2026, Published July 31, 2026

Abstract

Accurate intraoperative tumor margin assessment remains a major challenge in hepatobiliary and gastrointestinal cancer surgery, leading to residual disease and increased recurrence risk. Therefore, it is of interest to evaluate the diagnostic performance of intraoperative liquid biopsy (ctDNA, CTCs and exosomes) compared with frozen section histopathology in 90 patients undergoing oncological resection. The combined liquid biopsy panel achieved 93.4% sensitivity, 89.7% specificity and 90.3% concordance with R0 margin status, outperforming frozen section analysis in sensitivity. Liquid biopsy also demonstrated a lower re-excision rate and a shorter turnaround time, supporting its feasibility for real-time intraoperative decision-making. Thus, data shows the multi-analyte intraoperative liquid biopsy may enhance margin assessment accuracy and represent a promising adjunct to conventional frozen section evaluation.

Keywords

Intraoperative liquid biopsy, circulating tumor DNA (ctDNA), tumor margin detection, hepatobiliary surgery, gastrointestinal cancer, circulating tumor cells (CTCs)

Citation

Singh et al. Bioinformation 22(7): 3821-3824 (2026)

Edited by

Ruby Singh

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.