循环肿瘤DNA在子宫内膜癌应用中的临床价值探讨  

Clinical Value of Circulating Tumor DNA in Endometrial Carcinoma

作　　者：张天宏 张维娜[1] 张盛苗[1] 王雪 陈龙[1] ZHANG Tianhong;ZHANG Weina;ZHANG Shengmiao(Department of Obstetrics and Gynecology,Qingdao Municipal Hospital,Qingdao Shandong 266000,China)

机构地区：[1]青岛市市立医院妇产科,山东青岛266000

出　　处：《实用妇产科杂志》2020年第10期782-785,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨血液循环肿瘤DNA(ctDNA)在子宫内膜癌中应用的临床价值。方法:选择2017年3月1日至2017年10月31日于青岛市市立医院就诊的已明确诊断为子宫内膜癌的患者46例为研究对象,通过基因测序获得血液ctDNA结果,并比较不同分期(Ⅰ期与Ⅱ~Ⅲ期)、不同分型(Ⅰ型与Ⅱ型)、不同分级(G1~G2与G3)的子宫内膜癌患者间ctDNA的差异。结果:G1~G2级子宫内膜癌ctDNA阳性率24.14%(7/29),明显低于G3级ctDNA阳性率64.71%(11/17),差异有统计学意义(P=0.012)。Ⅰ期子宫内膜癌ctDNA阳性率为40.00%(12/30),与Ⅱ~Ⅲ期ctDNA阳性率37.50%(6/16)比较,差异无统计学意义(P=1.000)。Ⅰ型子宫内膜癌ctDNA阳性率41.03%(16/39),与Ⅱ型的ctDNA阳性率28.57%(2/7)比较,差异无统计学意义(P=0.688)。18例治疗前检测ctDNA阳性的患者,均在治疗结束后6个月检测ctDNA为阴性;46例患者中仅1例复发,此例为术前ctDNA检测阴性,术后6个月复查ctDNA呈阳性,并于1个月后出现影像学及临床肿瘤复发。结论:ctDNA与子宫内膜癌的分级具有一定的关系,能够反映子宫内膜癌的侵袭能力,但是其与子宫内膜癌的分期及分型的关系尚不明确。ctDNA可能对子宫内膜癌治疗后的疗效评价及复发预测有一定的价值。Objective:Toinvestigate the clinical value of Circulating Tumor DNA(ctDNA)in endometrial cancer.Methods:The data of 46 patients with endometrial carcinoma who were admitted to Qingdao Municipal Hospital from March 12017 to October 312017 were selected.ctDNA results were obtained by gene sequencing.The differences in ctDNA between patients with endometrial cancer of different stages(stageⅠand stageⅡ-Ⅲ),different types(typeⅠand typeⅡ),and different grades(G1-G2 and G3)were compared.Results:The ctDNA positive rate was 24.14%(7/29)in G1-G2 endometrial cancer,and 64.71%(11/17)in G3.The difference was statistically significant(P=0.012).The ctDNA positive rate was 40.00%(12/30)in stageⅠ,and 37.50%(6/16)in StageⅡ-Ⅲ.There was no significant difference between the two groups(P=1.000).The ctDNA positive rate was 41.03%(16/39)in typeⅠendometrial carcinoma and 28.57%(2/7)in typeⅡ.There was no significant difference in the two groups(P=0.688).All of the 18 patients with positive ctDNA before treatment were proved to be ctDNA negative 6 months after treatment.There was and only 1 patient relapsed,who was ctDNA negative before the operation and turnedto positive 6 months after the operation.Imaging and clinical tumor recurrence occurred 1 month later.Conclusions:ctDNA has a certain relationship with the grade of endometrial cancer,which could reflect the invasiveness of endometrial cancer.However,its relationship with the stage and type of endometrial cancer is still unclear.ctDNA may be valuable for the evaluation of efficacy and recurrence prediction of endometrial cancer after treatment.

关 键 词：子宫内膜癌 循环游离DNA 循环肿瘤DNA 液体活检 

分 类 号：R737.33[医药卫生—肿瘤]