ATM and neoplasm: In terms of consistency with tumor tissue, almost all of the gene mutations detected in the plasma ctDNA could be found in tumor DNA, and further analysis demonstrated that a decreased number and MAF of certain genes in plasma ctDNA could complement the therapeutic response of the patients, and patients with mutated KMT2D and ATM had poor prognosis, suggesting that the gene mutations in plasma could serve as promising biomarkers for use in the diagnosis or monitoring of ENKTL disease courses.