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. 2019 Sep 17;20(18):4588. doi: 10.3390/ijms20184588

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© 2019 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Liquid biopsy for diagnosis, prognosis, and treatment of diseases. Liquid biopsy is applicable to blood, saliva, urine, stool, semen, sweat, tear, nasal mucus, milk, and cerebrospinal fluid. Blood analytes are composed of cell-free proteins, circulating cell-free DNA (cfDNA), circulating cell-free RNA (cfRNA), circulating cell-free microRNA (cfmiRNA), circulating tumor DNA (ctDNA), EVs e.g. exosomes or oncosomes, circulating tumor cells (CTCs), tumor-educated blood platelets (TEPs), and metabolites. HSPs can be released from tissues upon cellular/tissue stress, damage, cell death, and hypoxia. Such ex-HSPs in body fluids are free proteins, protein complex, ribonucleoprotein (RNP) complexes, or HSP-rich EVs. ex-HSPs also belong to alarmins, DAMPs, or tumor associated antigens (TAAs) stimulating the host immune system. HSPs in body fluids may be a diagnostic or prognostic value as a cancer biomarker. The depletion of HSPs in the blood may prevent cancer progression and resistance.