基于术前和术后基因组信息的胰腺导管腺癌患者预后的精确分层。

IF 6 2区 医学 Q1 ONCOLOGY
Kokichi Miyamoto, Ryuichi Yoshida, Kazuya Yasui, Kunitoshi Shigeyasu, Kazuhiro Yoshida, Tomokazu Fuji, Kosei Takagi, Yuzo Umeda, Kazuyuki Matsumoto, Yuki Fujii, Toshiaki Takahashi, Kazuya Moriwake, Masashi Kayano, Takeyoshi Nishiyama, Yasuo Nagai, Hideki Yamamoto, Hironari Kato, Hiroshi Tazawa, Mizuki Morita, Motoyuki Otsuka, Toshiyoshi Fujiwara
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引用次数: 0

摘要

背景:胰腺导管腺癌(Pancreatic ductal adencarcinoma, PDAC)是所有癌症中死亡率最高的;因此,多学科治疗对PDAC患者至关重要。尽管可切除状态、肿瘤标志物、KRAS循环肿瘤DNA (mutKRAS-ctDNA)突变和GATA结合6 (GATA6)表达状态是有希望的预后生物标志物,但它们在手术前后的有效整合尚不清楚。方法:在这项回顾性队列研究中,纳入了接受根治性切除术的PDAC患者,并使用Cox风险模型确定与预后不良相关的术前和术后独立因素。使用确定的预后因素开发了风险分层系统,并调查了预测预后的能力。结果:共纳入91例PDAC患者(中位随访时间为28个月)。诊断时边缘可切除或局部晚期癌症、碳水化合物抗原19-9 (CA19-9)水平升高、mutkras - ctdna阳性状态被确定为与预后不良相关的独立术前因素。术后与总生存期缩短显著相关的因素是GATA6低表达、CA19-9水平升高和mutkras - ctdna阳性。最后,采用Cox模型风险比值建立的术前和术后风险评分系统可以对PDAC根治性切除后的预后进行显著分层。结论:基于液体活检的风险分层系统,专门针对每个阶段(术前和术后),已被证明是一种有用,简单,实用的预后预测临床工具,可确定PDAC的最佳多学科治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Precise stratification of prognosis in pancreatic ductal adenocarcinoma patients based on pre- and postoperative genomic information.

Background: Pancreatic ductal adenocarcinoma (PDAC) has the highest mortality rate among all cancers; hence, multidisciplinary treatment is essential for patients with PDAC. Although the resectability status, tumour marker, KRAS circulating tumour DNA (mutKRAS-ctDNA) mutations, and GATA binding 6 (GATA6) expression status are promising prognostic biomarkers, their effective integration before and after surgery remains unclear.

Methods: In this retrospective cohort study, patients with PDAC who had undergone radical resection were enrolled, and pre- and postoperative independent factors associated with poor prognosis were identified using Cox hazard modelling. Risk stratification systems were developed using the identified prognostic factors and investigated for the ability to predict prognosis.

Results: A total of 91 patients with PDAC were included (median follow-up duration, 28 months). Borderline resectable or locally advanced cancer at diagnosis, elevated carbohydrate antigen 19-9 (CA19-9) level, and mutKRAS-ctDNA-positive status were identified as independent preoperative factors associated with poor prognosis. The postoperative factors significantly associated with shorter overall survival were low GATA6 expression, elevated CA19-9 level, and mutKRAS-ctDNA-positive status. Finally, the preoperative and postoperative risk scoring systems developed using Cox modelling hazard ratio values could significantly stratify prognosis after curative resection for PDAC.

Conclusion: A risk stratification system based on liquid biopsy, specialised for each phase (pre- and post-surgery), has been proven to be a useful, simple, and practical prognostic prediction clinical tool to determine the optimal multidisciplinary treatment protocol for PDAC.

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来源期刊
CiteScore
10.90
自引率
1.70%
发文量
360
审稿时长
1 months
期刊介绍: Cancer Cell International publishes articles on all aspects of cancer cell biology, originating largely from, but not limited to, work using cell culture techniques. The journal focuses on novel cancer studies reporting data from biological experiments performed on cells grown in vitro, in two- or three-dimensional systems, and/or in vivo (animal experiments). These types of experiments have provided crucial data in many fields, from cell proliferation and transformation, to epithelial-mesenchymal interaction, to apoptosis, and host immune response to tumors. Cancer Cell International also considers articles that focus on novel technologies or novel pathways in molecular analysis and on epidemiological studies that may affect patient care, as well as articles reporting translational cancer research studies where in vitro discoveries are bridged to the clinic. As such, the journal is interested in laboratory and animal studies reporting on novel biomarkers of tumor progression and response to therapy and on their applicability to human cancers.
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