血浆游离DNA含量和完整性的动态变化在食管癌中的临床价值  

Clinical value of dynamic changes of plasma cell free DNA content and integrity in esophageal carcinoma

作　　者：马春芳 李翔翔 杨鸿林 MA Chunfang;LI Xiangxiang;YANG Honglin(Author Affiliation:Laboratory Department of Suzhou Ninth People's Hospital,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州市第九人民医院检验科,江苏苏州215000

出　　处：《安徽医药》2023年第10期1986-1990,共5页Anhui Medical and Pharmaceutical Journal

基　　金：苏州市第九人民医院院级科研启动基金立项(YK202226)。

摘　　要：目的探讨食管癌病人血浆游离DNA(cf-DNA)的含量和完整性(以cf-DNA长片段ALU247与短片段ALU115含量的比值表示)在食管癌诊治中的临床意义。方法选择2020年6月至2022年5月苏州市第九人民医院收治的50例食管癌病人、50例食管良性肿瘤病人、50例健康对照者为前瞻性研究的研究对象,分别纳入食管癌组、食管良性病变组以及健康对照组,用微量血液基因组提取试剂盒(Qiagen)提取血浆cf-DNA,并以实时荧光定量PCR法检测cf-DNA含量,收集其中25例食管癌病人术后血浆并检测cf-DNA含量,动态监测cf-DNA在术前术后的变化。检测食管癌病人糖类抗原199(CA199)、癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC)含量,比较cf-DNA和肿瘤标志物在食管癌中的诊断价值。结果食管癌组、良性病变组、健康对照组术前食管癌血浆ALU115含量[4.30(2.06,8.36)μg/L,1.98(1.38,3.02)μg/L,1.63(0.87,2.66)μg/L];ALU247含量[1.40(0.91,4.10)μg/L,0.63(0.37,1.27)μg/L,0.26(0.15,0.43)μg/L];cf-DNA完整性[0.41(0.29,0.69),0.33(0.25,0.50),0.18(0.11,0.28)](均P<0.05);ALU115[术前4.41(2.04,8.87)μg/L,术后1.05(0.66,1.75)μg/L]以及完整性[术前0.49(0.27,0.77),术后0.30(0.17,0.37)]在术前术后相比差异有统计学意义(P<0.05);在食管癌分期、分化程度、是否有远处转移上血浆cf-DNA差异有统计学意义(P<0.05);相比传统肿瘤标志物,血浆cf-DNA的诊断效能更高,当ALU247含量取0.65μg/L时,受试者操作特征(ROC)曲线下面积最大,为0.95。结论血浆cf-DNA检测在食管癌诊治、预后中有一定的临床价值。Objective To investigate the clinical significance of plasma cell free DNA(cf-DNA)content and integrity in the diagnosis and treatment of esophageal cancer.Methods Fifty patients with esophageal cancer,50 patients with benign esophageal tumors,and 50 healthy controls admitted to the Suzhou Ninth People's Hospital from June 2020 to May 2022 were selected as study subjects for the prospective study,and were included in the esophageal cancer group,the group with benign esophageal lesions,and the control group,respectively.A micro blood genome extraction kit(Qiagen)was used to extract cf-DNA,and real-time fluorescence quantitative PCR was utilized to evaluate the plasma cf-DNA content.The postoperative plasma of 25 esophageal cancer patients was collected,and the cf-DNA content was quantified,as well as the variations in cf-DNA before and after surgery,which were dynamically identified.At the same time,the levels of tumor markers carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)and squamous cell carcinoma antigen(SCC)were also examined in patients with esophageal cancer to compare the difference between the diagnostic significance of cf-DNA and tumor markers in esophageal cancer.Results Preoperative plasma ALU115 content in esophageal cancer[4.30(2.06,8.36)μg/L,1.98(1.38,3.02)μg/L,1.63(0.87,2.66)μg/L];ALU247 content[1.40(0.91,4.10)μg/L,0.63(0.37,1.27)μg/L,and 0.26(0.15,0.43)μg/L];and free DNA integrity[0.41(0.29,0.69),0.33(0.25,0.50),0.18(0.11,0.28)]in the esophageal cancer group,benign lesion group and healthy control group,showed statistically significant differences among the three groups(P<0.05);The difference in ALU115[preoperative 4.41(2.04,8.87)μg/L,postoperative 1.05(0.66,1.75)μg/L]as well as integrity[preoperative 0.49(0.27,0.77),postoperative 0.30(0.17,0.37)]was statistically significant when compared before and after surgery(P<0.05);Additionally,there were statistical differences in plasma cf-DNA according to the stage,level of differentiation,and existence of distant metastases in esop

关 键 词：食管肿瘤 血浆游离DNA 糖类抗原199(CA199) 癌胚抗原(CEA) 鳞状上皮细胞癌抗原(SCC) 

分 类 号：R735.1[医药卫生—肿瘤]