基于克隆进化原理的循环肿瘤DNA在前列腺癌疗效监测中的应用

Application of circulating tumor DNA based on clonal evolution in the clinical monitoring of prostate cancer progression

目的:开展基于克隆进化原理的循环肿瘤DNA在晚期前列腺癌临床监测中的探索性应用研究。方法:纳入2例临床特征为低前列腺特异性抗原(prostate-specific antigen, PSA)且高风险的晚期前列腺癌患者,通过前列腺多区域取材进行DNA测序以构建肿瘤的克隆进化过程;针对肿瘤亚克隆设计循环肿瘤DNA(circulating tumor DNA,ctDNA)探针,结合患者相关临床指标,评估其在晚期前列腺癌治疗监测中的价值。结果:基于克隆进化原理的ctDNA监测可表现出比PSA等传统指标更早的肿瘤进展预警。结论:本研究为晚期前列腺癌患者的疗效监测和长程管理提供了新的可行性。

Objective To conduct an exploratory research on the application of circulating tumor DNA(ctDNA)in the clinical monitoring of advanced prostate cancer based on the clonal evolution analysis.Methods Two cases of advanced prostate cancer patients with clinical characteristics of low prostate-specific antigen(PSA)and high risk were included,and DNA sequencing was performed on multiple regions of the prostate to construct tumor clonal evolution.We designed ctDNA probes specific to tumor subclones,integrating relevant clinical indicators of the patients to assess its value in monitoring late-stage prostate cancer treatment.Results The ctDNA monitoring based on the principles of clonal evolution can provide earlier warnings of tumor progression compared to traditional indicators such as PSA.Conclusion This study provides a novel feasibility for efficacy monitoring and long-term management of advanced prostate cancer patients.