Minimal residual disease (MRD) refers to the trace amount of tumor cells remaining in the body after treatment, which is regarded as the core driving factor for postoperative recurrence of pulmonary carcinoma. Circulating tumor DNA (ctDNA) is a nucleic acid fragment released into the blood after apoptosis or necrosis of tumor cells. It has the advantages of non⁃invasive, repeatable and dynamic monitoring, which can be used not only for early diagnosis of pulmonary carcinoma, but also for accurate detection of MRD and prediction of recurrence risk, providing a new molecular strategy for the full⁃cycle diagnosis and treatment of pulmonary carcinoma. This paper systematically summarizes the main detection technologies of ctDNA and their advantages and disadvantages, focuses on the research progress of ctDNA in early diagnosis of pulmonary carcinoma, postoperative recurrence prediction based on MRD⁃monitoring and adjuvant therapy guidance, analyzes the challenges in the current clinical translation, and prospect the future clinical application, aiming to provide a reference for the standardized application of ctDNA in early diagnosis and MRD monitoring of pulmonary carcinoma.

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