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BMC Gastroenterology:结肠癌手术患者围手术期游离 DNA 的变化

2022-04-12 xuyihan MedSci原创

生理情况下,血液中的cfDNA主要来源于白细胞的坏死和凋亡,在某些疾病和特殊状态下,其他细胞也会释放游离DNA入血,包括来源于肿瘤细胞的循环肿瘤DNA(ctDNA)和来源于胎儿的cfDNA等。

局部结直肠癌 (CRC) 的根治性治疗仍然是手术。然而,在根治性手术之后,患有 3 期癌症的患者仍有 33% 的复发风险,这是导致 CRC 发病率和死亡率的主要原因。手术还可能对患者造成有害的并发症,具有长期的副作用和再入院,以及延长辅助化疗的时间,从而减弱化疗对肿瘤学结果的影响。识别具有高风险手术并发症的患者可以实现有针对性的围手术期方案,并增加患者监测。因此,能够预测患者并发症或复发风险是否增加的准确的手术指标生物标志物将是有价值的。血浆中发现的核酸是恶性疾病患者疾病复发的有希望的生物标志物。它们可以作为游离 DNA (cfDNA) 进行测量,存在于各种体液中,例如粪便、尿液、脑脊液和胸腔积液。先前的研究表明,CRC 患者的 cfDNA 水平高于健康个体,来自线粒体的 cfDNA 子集已被证明可作为损伤相关的分子模式。在这项探索性研究中,研究人员将探究不同的手术方法、手术并发症或后期复发是否会影响结肠癌患者围手术期 cfDNA 浓度。

 

研究人员从入院时和出院时接受结肠癌手术的患者中获得本项试验所需的血浆样本。通过分别扩增 102 个碱基对 (bp) 和 132 bp 的Beta-2-微球蛋白( B2M ) 和肽酰-脯氨酰顺反异构酶 A ( PPIA )的两个扩增子来进行 cfDNA 的定量测,最后与患者的临床结局进行了相关性分析。

 

本项研究共在 48 名接受结肠癌手术的患者中测量了 cfDNA。随访期间有16例出现复发,15例出现术后并发症,17例未出现。在所有组中,术后 cfDNA 水平均较基线样本显着升高,术前B2M水平中位数为 48.3 个等位基因/mL,术后中位数为 220 个等位基因/mL,术前中位PPIA水平为 26.9 个等位基因/mL,术后中位数为 111.6 个等位基因/mL。出现并发症的患者术后 PPIA 水平显着高于对照组(p=0.036)。然而,未发现PPIA ( p=0.058) 和 B2M ( p= 0.087)与手术方法和 cfDNA 水平变化之间存在关联的趋势。

 

本项研究证实所有结肠癌患者手术后血浆 cfDNA 均增加。经历手术并发症的患者术后 PPIA 水平显着升高,但 B2M 水平则不然。

 

原始出处

Andreas W. Rosen. Et al. Perioperative changes in cell-free DNA for patients undergoing surgery for colon cancer. BMC Gastroenterology.2022.

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    2022-07-27 许安
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    2022-04-12 仁术2021

    不错,学习了。

    0

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DCR:他汀类药物治疗与结肠癌手术后 90 天术后死亡率降低有关

他汀类药物,即3-羟基-3甲基戊二酰辅酶A(HMG-CoA)还原酶抑制药,不仅能强效地降低总胆固醇(TC)和低密度脂蛋白(LDL),而且能一定程度上降低三酰甘油(TG),还能升高高密度脂蛋白(HDL)

Dig Dis Sci:天冬氨酸氨基转移酶与血小板比率指数可以预测结直肠癌肝转移患者术后肝功能衰竭的风险

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

Eur J Cancer:糖尿病和服用二甲双胍对结肠癌患者复发风险及预后的影响

与不合并糖尿病的结肠癌患者相比,合并糖尿病的结肠癌患者的复发时间更短,生存预后更差

BMC Gastroenterology: 结直肠癌根治性术后患者疾病复发的危险因素

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。

DCR:直肠系膜与筋膜的距离与 cT3 直肠癌预后的相关性分析

结肠癌是常见的发生于结肠部位的消化道恶性肿瘤,结肠癌与人们食用红肉(如牛肉)有着很大的相关性。好发于直肠与乙状结肠交界处,以40~50岁年龄组发病率最高,男女之比为2~3:1。

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