循环肿瘤DNA检测作为弥漫大B细胞淋巴瘤早期预后预测指标的可行性研究

Feasibility study of circulating tumor DNA detection as an early prognostic indicator for diffuse large B cell lymphoma

目的研究循环肿瘤DNA(ctDNA)作为弥漫大B细胞淋巴瘤(DLBCL)患者早期预后预测指标的可行性。方法选取新疆维吾尔自治区人民医院血液病科2020年1月-2021年12月收入的50例DLBCL患者为观察组,另选同期50例健康体检者为对照组。采集空腹静脉血测定血浆ctDNA并对比,采用Spreaman相关性分析法检验血浆ctDNA与DLBCL患者Ann Anbor分期、分型、C-MYC测定结果的相关性,绘制受试者操作特征曲线(ROC)评价ctDNA检测早期预测DLBCL患者预后的价值。结果观察组与对照组比较,观察组内不同Ann Anbor分期、分型、C-MYC测定结果、治疗时间段、疗效患者的血浆ctDNA差异均具有统计学意义(P<0.05);Spreaman相关性分析结果显示,血浆ctDNA与DLBCL患者Ann Anbor分期、分型、C-MYC测定结果均呈正相关关系(r=0.74、0.80、0.85,P<0.05);ROC显示,血浆ctDNA预测DLBCL患者预后的截断值为8.88 ng/mL,曲线下面积、灵敏度、特异度分别为0.945、93.18%、83.33%。结论在DLBCL患者早期预后预测中血浆ctDNA可作为重要预测指标加以推广使用。

Objective To investigate the feasibility of circulating tumor deoxyribonucleic acid(ctDNA) as an early prognosis predictor in patients with diffuse large B cell lymphoma(DLBCL). Methods 50 patients with DLBCL who were admitted to the Hematology Department of People’s Hospital of Xinjiang Uygur Autonomous Region from January 2020 to December 2021 were selected as an observation group, and another 50healthy people in the same period were selected as the control group. Fasting venous blood was collected to measure plasma ctDNA and to make a comparison. Spreadman correlation analysis was used to examine the correlation between plasma ctDNA and Ann Arbor stage, classification and C-MYC measurement results of patients with DLBCL. The receiver operator characteristic curve(ROC) was drawn to evaluate the value of ctDNA detection in predicting the prognosis of patients with DLBCL in the early stage. Results There were statistically significant differences in plasma ctDNA between the subjects in the observation group and the control group, in different Ann Arbor stages, classifications and C-MYC determination results, different treatment periods, and patients with different therapeutic effects in the observation group(P < 0.05);Spreaman correlation analysis showed that plasma ctDNA was positively correlated with the Ann Anbor stage,classification and C-MYC determination in patients with DLBCL(r = 0.74, 0.80, 0.85, P < 0.05);ROC showed that the cutoff value of plasma ctDNA for predicting the prognosis of patients with DLBCL was 8.88ng/mL, and the area under the curve, sensitivity and specificity were 0.945, 93.18% and 83.33% respectively.Conclusion Plasma ctDNA can be widely used as an important predictor in the early prognosis prediction of patients with DLBCL.