腹膜无细胞DNA作为检测结直肠癌腹膜转移的敏感生物标志物:一项前瞻性诊断研究

IF 5.7 2区 医学 Q1 Medicine
Zixu Yuan, Wenle Chen, Duo Liu, Qiyuan Qin, William M Grady, Alessandro Fichera, Huaiming Wang, Ting Hou, Xinze Lv, Chanhe Li, Hui Wang, Jian Cai
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引用次数: 2

摘要

背景:腹膜转移(PM)的检测受到现有影像学工具的限制。在这项前瞻性研究中,我们旨在评估腹膜无细胞DNA (cfDNA)诊断PM的敏感性和特异性。方法:纳入伴有/不伴有PM的结直肠癌(CRC)患者。cfDNA实验人员和统计人员对PM的诊断不知情。对腹膜灌洗液(FLD)和匹配肿瘤组织中的cfDNA进行覆盖大基因组区域的超深度测序(35000X,下一代测序)。结果:共前瞻性纳入64例,最终纳入51例。在训练队列中,100% (17/17)PM患者获得FLD cfDNA阳性,而非PM患者为5/23(21.7%)。腹膜cfDNA诊断PM的敏感性为100%,特异性为77.3% (AUC: 0.95)。验证组11例中,5/6 (83%)PM患者FLD cfDNA阳性,非PM患者为0/5 (P = 0.031),敏感性为83.3%,特异性为100%。FLD cfDNA阳性与较差的无复发生存率相关(P = 0.013),是复发的影像学证据。结论:腹膜cfDNA是一种有希望的敏感生物标志物,可以比目前的放射学工具更早地检测结直肠癌中的PM。它可以潜在地指导靶向治疗的选择,并在未来替代腹腔镜探查。中国临床试验注册网站chictr.org.cn (ChiCTR2000035400)。URL: http://www.chictr.org.cn/showproj.aspx?proj=57626。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Peritoneal cell-free DNA as a sensitive biomarker for detection of peritoneal metastasis in colorectal cancer: a prospective diagnostic study: A prospective diagnostic study.

Peritoneal cell-free DNA as a sensitive biomarker for detection of peritoneal metastasis in colorectal cancer: a prospective diagnostic study: A prospective diagnostic study.

Peritoneal cell-free DNA as a sensitive biomarker for detection of peritoneal metastasis in colorectal cancer: a prospective diagnostic study: A prospective diagnostic study.

Peritoneal cell-free DNA as a sensitive biomarker for detection of peritoneal metastasis in colorectal cancer: a prospective diagnostic study: A prospective diagnostic study.

Background: The detection of peritoneal metastasis (PM) is limited by current imaging tools. In this prospective study, we aimed to evaluate the sensitivity and specificity of peritoneal cell-free DNA (cfDNA) for diagnosis of PM.

Methods: Colorectal cancer (CRC) patients with/without PM were enrolled. The cfDNA experimental personnel and statists were blinded to the diagnosis of PM. Ultradeep sequencing covering large genomic regions (35000X, Next-generation sequencing) of cfDNA in peritoneal lavage fluid (FLD) and matched tumor tissues was performed.

Results: A total of 64 cases were recruited prospectively and 51 were enrolled into final analysis. In training cohort, 100% (17/17) PM patients obtained positive FLD cfDNA, comparing to 5/23 (21.7%) in patients without PM. Peritoneal cfDNA had a high sensitivity of 100% and specificity of 77.3% for diagnosis of PM (AUC: 0.95). In validation group of 11, 5/6 (83%) patients with PM obtained positive FLD cfDNA, comparing to 0/5 in non-PM (P = 0.031) with a sensitivity of 83.3% and specificity of 100%. Positive FLD cfDNA was associated with poor recurrence-free survival (P = 0.013) and was preceding radiographic evidence of recurrence.

Conclusions: Peritoneal cfDNA is a promising sensitive biomarker for earlier detection of PM in CRC than current radiological tools. It can potentially guide selection for targeted therapies and serve as a surrogate instead of laparoscopic explore in the future. Trial Registration Chinese Clinical Trial Registry at chictr.org.cn (ChiCTR2000035400). URL: http://www.chictr.org.cn/showproj.aspx?proj=57626.

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来源期刊
Clinical Epigenetics
Clinical Epigenetics Biochemistry, Genetics and Molecular Biology-Developmental Biology
CiteScore
8.90
自引率
5.30%
发文量
150
审稿时长
12 weeks
期刊介绍: Clinical Epigenetics, the official journal of the Clinical Epigenetics Society, is an open access, peer-reviewed journal that encompasses all aspects of epigenetic principles and mechanisms in relation to human disease, diagnosis and therapy. Clinical trials and research in disease model organisms are particularly welcome.
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