PAP动态监测血浆cfDNA在进展期非小细胞肺癌患者治疗中的应用

Application of PAP PCR to monitor plasma cf DNA in advanced non-small cell lung cancer

目的:探讨焦磷酸化激活聚合反应(pyrophosphorolysis-activated polymerization,PAP)动态监测血浆cf DNA在进展期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者治疗中的应用。方法:收集2016年3月至2017年6月就诊的进展期NSCLC患者85例,采用PAP核酸扩增实时荧光PCR法与扩增阻滞突变系统(amplication refractory mutation system,ARMS)实时荧光PCR法检测血浆cf DNA的EGFR突变状况,比较组织与血浆及PAP法与ARMS-PCR检测结果的一致性;对突变阳性的38例患者采用PAP动态监测血浆基因突变状况。结果:血浆与组织突变检测结果差异无统计学意义(P=0.092)。PAP与ARMS-PCR突变检测结果差异亦无统计学意义(P=0.210)。血浆cf DNA EGFR基因突变的检出率,在疾病进展者中较未进展者中高(62.5%vs.21.3%,P<0.001)。结论:PAP可用于血浆cf DNA突变检测及动态监测以提前获得疾病进展的信息。

Objective： To explore the application of pyrophosphorolysis-activated polymerization （PAP） to monitor plasma cfDNA in advanced non-small cell lung cancer （NSCLC）. Methods： A total of 85 patients diagnosed with advanced NSCLC between March 2016 and June 2017 were enrolled in the present study. EGFR mutations in cfDNA extracted from the plasma were detected using PAP and ARMS-PCR technology. The concordance analysis of EGFR mutations involved plasma vs. tumor tissue and PAP vs. ARMS-PCR. Furthermore, 38 EGFR-positive patients were selected to monitor EGFR mutations with PAP. Results： No statistical differences in EGFR mutations were observed between plasma and tumor tissue （P=0.092）, as well as PAP and ARMS-PCR （P=0.210）. The detection rate of EGFR mutations in cfDNA was higher in the progressor than in the non-progressor （62.5% vs. 21.3%, P〈0.001）. Conclusions： PAP can be used for detecting and monitoring EGFR mutations in cfDNA to predict disease progression.