血浆DNA定量检测在晚期肺癌患者个体化治疗中的应用  

Plasma DNA monitoring in personalized medicine for patients with advanced lung cancer

作　　者：夏文颖[1,2] 丁清清[3] 潘世扬[1,2] 束永前[3] 徐婷[1,2] 陆雅春[1,2] 耿雁[1,2] 陈丹[1,2] 黄珮珺[1,2] 黄蕾[1,2] 徐建[1,2] 

机构地区：[1]南京医科大学第一附属医院医学检验科,南京210029 [2]南京医科大学第一附属医院江苏省实验诊断学重点实验室,南京210029 [3]南京医科大学第一附属医院肿瘤科,南京210029

出　　处：《临床检验杂志》2010年第3期185-187,共3页Chinese Journal of Clinical Laboratory Science

基　　金：国家自然科学基金(30972821);江苏省自然科学基金(BK2009440);江苏省实验诊断学重点实验室基金(XK200731);江苏省卫生厅重大项目科研基金(H200707);江苏省科技厅社会发展基金(BS2007073)

摘　　要：目的通过监测晚期肺癌患者化疗过程中血浆DNA水平的变化,探讨其在疗效预测以及个体化治疗中的应用。方法采集35名晚期肺癌患者化疗前、后静脉血,用磁珠法提取血浆循环DNA和内参照质粒DNA,双重荧光定量PCR技术进行DNA定量检测,以100名体检健康者为对照。结果晚期肺癌患者化疗前血浆DNA平均含量为66.4（33.1-105.0）ng/ml,显著高于健康对照组血浆DNA平均含量22.4（16.2-30.0）ng/ml（P〈0.01）。一线药物化疗后,部分缓解组肺癌患者血浆DNA值较化疗前显著下降（P〈0.01）,且与病情稳定组、病情进展组患者血浆DNA值有显著差异（P均〈0.05）,而与健康对照组已无差异。生存曲线分析显示,化疗后血浆DNA〈50 ng/ml的患者生存率高于血浆DNA≥50 ng/ml的患者（P〈0.01）。结论血浆DNA的变化可敏感地反映晚期肺癌患者化疗疗效,在肿瘤个体化治疗中发挥重要作用。Objective This study aimed to evaluate the quantification of plasma DNA as a marker for monitoring chemotherapeutic efficacy in personalized medicine for patients with advanced lung cancer.Methods Thirty-five lung cancer patients and 100 healthy controls were included.Plasma DNA was extracted with the BILATEST DNA Kit.The plasma DNA was quantitatively determined by duplex real-time PCR.Results In patients with advanced lung cancer,the median value of plasma DNA before chemotherapy was 66.4（33.1-105.0） ng/ml,significantly higher than that（22.4 ng/ml,16.2-30.0） in healthy controls（P〈0.01）.After the first-line chemotherapy,plasma DNA in patients with partial response significantly decreased,compared with the baseline concentrations（P〈0.01）,and was significantly different from that in patients without response or with disease progression（P〈0.05）,but had no statistical difference compared with that in healthy controls.Patients who had lower levels of plasma DNA after the chemotherapy had longer survival time（P〈0.01）.Conclusions The quantification of plasma DNA is a sensitive indicator of chemotherapeutic efficacy,and it may be useful in personalized medicine for patients with advanced lung cancer.

关 键 词：晚期肺癌 化疗 个体化治疗 血浆DNA 

分 类 号：R734.2[医药卫生—肿瘤]