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基于循环肿瘤细胞和无细胞核酸的液体活检在从诊断到随访的整个癌症自然过程中的多个时间点都有潜在的应用前景。与基于组织的基因组图谱相比，进行循环肿瘤DNA（ctDNA）评估的优势在于检测风险最小，可进行连续检测以监测疾病的复发和对治疗的反应，并在整个过程中降低住院费用。在局限性肾细胞癌中，ctDNA已显示出作为疾病复发的监测生物标志物的潜力。在症状发作之前及早发现转移可能会改善临床结果。在患有转移性肾细胞癌（mRCC）患者中，ctDNA更具前景。大多数mRCC患者具有可检测的ctDNA，因此ctDNA可用于选择生物标志物指导的临床患者。研究表明，mRCC中的ctDNA突变情况在治疗后会发生改变。在mRCC中ctDNA还有作为对免疫疗法反应的预测性生物标志物的潜在作用；此外，ctDNA可作为肿瘤突变负荷和对免疫疗法反应的替代生物标志物。随着技术的进步，ctDNA未来有可能影响肾细胞癌的诊断和治疗。“,”Liquid biopsy based on circulating tumor cells and cell-free nucleic acids has potential applications at multiple time points in the natural cancer process from diagnosis to follow-up. Compared with tissue-based genome maps, the advantage of circulating tumor DNA (ctDNA) assessment is that the detection risk is minimal, and the recurrence of the disease and the response to treatment can be continuously monitored, thereby reducing the cost of the entire treatment process. In localized renal cell carcinoma, ctDNA has shown potential as a monitoring biomarker for disease recurrence. Early detection of metastases before the onset of symptoms may improve clinical outcomes. In patients with metastatic renal cell carcinoma (mRCC), ctDNA is more promising. Most patients with mRCC have detectable ctDNA. Therefore, ctDNA can be used to select clinical patients guided by biomarkers. Studies have shown that the ctDNA mutations in mRCC will change after treatment. In mRCC, ctDNA also has a potential role as a predictive biomarker of immunotherapy response. In addition, ctDNA can be used as a surrogate biomarker for tumor mutational burden and response to immunotherapy. With the advancement of technology, ctDNA may affect the diagnosis and treatment of renal cell carcinoma in the future.