摘要
目的定量分析结直肠癌患者血浆游离DNA（cfDNA）水平在结直肠癌诊断及预后判断中的临床价值。方法收集本院接受手术的结直肠癌患者手术当天血浆标本178份和正常人血浆56份。利用实时定量聚合酶链反应（Real-time PCR）检测血浆cfDNA水平。利用ROC曲线评价cfDNA水平在结直肠癌各分期亚组的诊断价值。对Ⅳ期患者进行随访，分析cfDNA与患者生存期之间的相关性。结果结直肠癌组cfDNA浓度显著高于健康体检组，差异有统计学意义[（63.07±65.38） ng/ml比（22.85±8.88） ng/ml，P＝0.000）]。Ⅲ～Ⅳ期结直肠癌组与健康体检组比较差异有统计学意义[血浆cfDNA浓度分别为（39.59±31.56）、（107.32±102.85） ng/ml比（22.85±8.88） ng/ml，均P＝0.000）]。血浆cfDNA水平在高、中、低分化肿瘤中分别为（29.42±18.29）、（54.69±75.05）、（9.67±103.18） ng/ml，差异有统计学意义（P＝0.000）。血浆cfDNA水平TNM分期密切相关。生存分析结果显示血浆cfDNA浓度与肿瘤患者总生存期（OS）明显相关。结论血浆cfDNA水平对结直肠癌早期诊断价值有限，初次治疗时血浆cfDNA浓度是有效的预后指标。
Objective To determine the diagnostic and prognostic value of quantitative estimates of cell-free DNA （cfDNA） in coloretal cancer （CRC）.Methods The study included 178 patients at different stages of CRC and 56 healthy donors. The plasma cfDNA was determined using real-time quantitative polymerase chain reaction（Real-time PCR） amplification of the β-actin gene （99 bp）. Receiver operating characteristic （ROC） curve was applied to analyze the diagnostic value of cfDNA level. The patients of stage Ⅳ were followed up to determine the prognostic value of cfDNA.Results The cfDNA levels were higher in CRC patients than those in health controls [（63.07±65.38） vs. （22.85±8.88） ng/ml, P=0.000]. The cfDNA levels were also higher in CRC patients of Ⅲ-Ⅳ stage than those in health controls [（39.59±31.56） and （107.32±102.85） ng/ml vs. （22.85±8.88） ng/ml, P=0.000 for all]. Association was observed among plasma cfDNA level and histologic grading [（29.42±18.29）, （54.69±75.05）, （9.67±103.18） ng/ml, P=0.000] as well as TNM stage （P=0.000）. Survival analysis confirmed that high cfDNA levels were clear indicators of a poor over survival.Conclusion This study shows that the baseline cfDNA levels in plasma of CRC patients has no value in the early diagnosis of CRC, but is an effective prognosis biomarker.
作者
郑照正
闵丽姗
钱福初
张贵阳
陈莹蓉
钟婧
马志红
戴利成
蒋微琴
Zheng Zhaozheng, Min Lishan, Qian Fuchu, Zhang Guiyang, Chen Yingrong, Zhong Jing, Ma Zhihong, Dai Licheng, Jiang Weiqin(Department of Colorectal Surgery, Huzhou Central Hospital, Huzhou 313000, China ;Huzhou Key Laboratory of Molecular Medicine, Huzhou Central Hospital, Huzhou 313000, China ;Cancer Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2018年第3期529-532,共4页
Chinese Journal of Experimental Surgery
基金
湖州市重点科技创新团队项目（2013KC02）
湖州市公益性技术应用研究项目（2013GYB08）
关键词
结直肠癌
循环游离DNA
荧光定量聚合酶链反应
Colorectal cancer
Cell-free DNA
Real-time quantitative polymerase chain reaction
