Role of preoperative circulating tumor DNA in predicting occult metastases in resectable and borderline resectable pancreatic ductal adenocarcinoma.

IF 5.4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

World Journal of Gastroenterology Pub Date : 2025-08-28 DOI:10.3748/wjg.v31.i32.109383

Takeshi Murakami, Masafumi Imamura, Yasutoshi Kimura, Kazunori Watanabe, Yoshihito Shinohara, Toru Nakamura, Siew-Kee Low, Masayo Motoya, Yujiro Kawakami, Yoshiharu Masaki, Tomohiro Kubo, Makoto Yoshida, Eiji Yoshida, Toru Kato, Kazuharu Kukita, Daisuke Kyuno, Ichiro Takemasa

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引用次数: 0

Abstract

Background: Some patients with resectable or borderline resectable pancreatic ductal adenocarcinoma (PDAC) may have distant metastases, undetected on preoperative imaging or early recurrence, within 6 months after surgery. Occult metastases (OMs) must be accurately predicted to optimize multidisciplinary treatment.

Aim: To investigate the efficacy of circulating tumor DNA (ctDNA) in predicting OM.

Methods: Two Japanese institutions prospectively collected preoperative plasma samples from PDAC patients between July 2019 and September 2021 and evaluated ctDNA using a targeted next-generation sequencing panel covering 52 cancer-related genes.

Results: Among 135 PDAC patients, 38 had OM and 35 were positive for ctDNA. The ctDNA positivity rate was significantly higher in patients with OM than in patients without OM. ctDNA-positive patients had significantly shorter median recurrence-free survival than ctDNA-negative patients. Logistic multivariate regression revealed ctDNA positivity as an independent predictor of OM.

Conclusion: Preoperative ctDNA in resectable PDAC is an independent predictor of OM and indicates poor prognosis following pancreatectomy and may be a useful biomarker in determining multidisciplinary patient care.

Abstract Image

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术前循环肿瘤DNA在预测可切除和交界性可切除胰腺导管腺癌隐匿转移中的作用。

背景：一些可切除或交界性可切除的胰腺导管腺癌（PDAC）患者可能在手术后6个月内发生远处转移，术前影像学未发现或早期复发。隐匿性转移瘤（OMs）必须准确预测以优化多学科治疗。目的：探讨循环肿瘤DNA （ctDNA）在预测OM中的作用。方法：两家日本机构前瞻性地收集了2019年7月至2021年9月期间PDAC患者的术前血浆样本，并使用覆盖52个癌症相关基因的靶向下一代测序面板评估ctDNA。结果：135例PDAC患者中，38例有OM， 35例ctDNA阳性。有OM患者ctDNA阳性率明显高于无OM患者。ctdna阳性患者的中位无复发生存期明显短于ctdna阴性患者。Logistic多元回归显示ctDNA阳性是OM的独立预测因子。结论：可切除的PDAC患者术前ctDNA是OM的独立预测因子，表明胰腺切除术后预后不良，可能是确定多学科患者护理的有用生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

7.80

自引率

4.70%

发文量

464

审稿时长

2.4 months

期刊介绍： The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.