胃癌血浆游离DNA检测的临床意义

Clinical significance of detection of plasma cfDNA in gastric cancer

目的探讨游离DNA(cfDNA)在胃癌术后辅助治疗和晚期胃癌患者血液中的浓度和临床意义。方法选择术后辅助化疗胃癌患者71例和晚期胃癌化疗患者106例为研究对象,同期招募40例健康志愿者作为对照组。每周期化疗前采用(SuperbDNATM)杂交技术检测血浆cfDNA浓度,连续检测3个周期,评价化疗过程中cfDNA浓度变化与疗效的关系。结果化疗前晚期胃癌患者cfDNA浓度为(22.75±12.22)ng/ml,术后辅助化疗患者cfDNA浓度为(22.50±13.86)ng/ml,均高于健康对照组的(12.28±7.72)ng/ml,差异具有统计学意义(P<0.05)。晚期胃癌患者CEA水平与cfDNA浓度有关(P=0.048)。在晚期胃癌中,PR患者的血浆cfDNA浓度呈下降趋势,差异具有统计学意义(P<0.05);SD患者的血浆cfDNA浓度变化趋势差异无统计学意义;PD患者的血浆cfDNA浓度呈现上升趋势,差异具有统计学意义(P<0.05)。术后辅助化疗患者的血浆cfDNA浓度呈下降趋势,差异具有统计学意义(P<0.05)。结论胃癌患者的血浆cfDNA浓度显著升高,与传统肿瘤生物标志物无显著相关性,与化疗疗效呈负相关。因此,血浆cfDNA浓度可作为胃癌诊断与疗效判断的一个潜在指标。

Objective To investigate the concentration and clinical significance of cell-free DNA(cfDNA)in the blood of gastric cancer patients after adjuvant treatment and advanced gastric cancer.Methods Seventy-one patients with gastric cancer and 106 patients with advanced gastric cancer treated with adjuvant chemotherapy were selected as the study objects,and 40 healthy volunteers were recruited as the control group at the same time.Before each cycle of chemotherapy,the concentration of cfdna in plasma was detected by using the technique of superbdna ATM hybridization,and the relationship between the concentration of cfdna and the therapeutic effect was evaluated.Results The concentration of cfDNA was(22.75±12.22)ng/ml in patients with advanced gastric cancer before chemotherapy,and(22.50±13.86)ng/ml in patients with postoperative adjuvant chemotherapy,which was higher than that in the healthy control group(12.28±7.72)ng/ml,with a statistically significant difference(P<0.05).CEA level was related to cfDNA concentration in patients with advanced gastric cancer(P=0.048).In advanced gastric cancer,the plasma cfDNA concentration of PR patients showed a downward trend,the difference was statistically significant(P<0.05);the plasma cfDNA concentration of SD patients had no statistical significance;the plasma cfDNA concentration of PD patients showed an upward trend,the difference was statistically significant(P<0.05).The concentration of cfDNA in the plasma of patients with postoperative adjuvant chemotherapy showed a downward trend,the difference was statistically significant(P<0.05).Conclusion There was no significant correlation between cfDNA concentration and traditional tumor biomarkers,but negative correlation between cfDNA concentration and chemotherapy effect.Therefore,the plasma cfDNA concentration can be used as a potential index for the diagnosis and efficacy evaluation of gastric cancer.