Annals of Oncology :研究: 血检可检测多种癌症,可用于临床研究中的高危人群

2020-03-31 转化医学网 转化医学网

一项新血液测试的试验表明,一种正在开发的新血液测试能够以较高的准确性筛查多种类型的癌症。达纳-法伯癌症研究所的研究人员在2019年欧洲肿瘤医学协会(ESMO)大会上展示了多中心试验的结果。

涉及上***参与的一项新的血检检测出超过50种的癌症类型还有它们在体内的病灶部位,准确率特别高,这是来自达纳-法伯癌症研究所和梅奥诊所领导的一个国际研究小组的研究。

这一研究在2020年3月30日在线发表在《肿瘤学年鉴》上,表明这项血检测试在早期癌症检测中能够发挥至关重要的作用。它能够识别出一些缺乏标准筛查方法的特别危险的癌症。

这项测试由加利福尼亚门洛帕克的GRAIL公司开发,它使用下一代测序技术来分析癌细胞DNA上被称为甲基群的化学单位的排列。甲基群附着在DNA的特定部位上,有助于控制基因的活性和非活性。甲基群的位置或甲基化模式在癌细胞中和在正常细胞中明显不同。某种程度上说,异常的甲基化模式比基因变异更具有癌细胞的特征。当癌细胞死亡后,他们的DNA与甲黏附在一起,流入血液中,在那里用新的检测方法还能进行分析。

“我们之前的工作表明,基于甲基化的检测方法在检测血液样本中的多种癌症方面优于传统的DNA测序方法,”这项研究的达纳-法伯研究所的杰弗里·奥克斯纳德医学博士,与梅奥诊所的米内塔·刘医学博士说。“这项研究的结果表明,这些检测方法是检测各种癌症患者的可行方法。”

之前,这项测试由GRAIL公司开发,使用下一代测序技术探测DNA中微小的化学标记(甲基化),这些标记会影响基因的活性或非活性。当应用于近3600血液样本。,一些是有癌症患者的样本。一些是抽血时没有诊断出癌症的血液样本。这项测试成功挑选出癌症患者血液样本的癌症信号,并且准确识别出癌症早期的组织变化。研究人员发现,这种检测的特异性——只有在癌症确实存在的情况下才会有阳性结果的能力——很高,同时它还能准确定位器官或组织的来源。

这项新测试寻找的是癌细胞死亡时进入血液的DNA。与检测基因突变或其他与癌症相关的DNA改变的“液体活组织检查”不同,这项技术关注的是被称为甲基的DNA的改变。甲基是可以附着在DNA上的化学单位,这个过程被称为甲基化,以控制哪些基因是“开启”的,哪些是“关闭”的。在许多情况下,甲基化的异常模式比突变更能说明癌症和癌症类型。这项新的测试瞄准了在癌细胞中发现异常甲基化模式的基因组部分。

这项研究中,研究者们利用测试分析了6689份血液样本的游离DNA(在细胞死亡时进入血液的正常细胞和癌细胞的DNA)其中包括2482份癌症患者的血液样本和4207份非癌症患者的血液样本。癌症的患者的血液样本中有超过50种癌症类型,包括乳腺癌,结直肠癌、食道癌、胆囊癌、膀胱癌、胃癌、卵巢癌、头颈肿瘤、肺癌、淋巴性白血病、多发性骨髓瘤、胰腺癌等。

总体上,测试的准确率高达99.3%,意味着仅仅有0.7%的鉴别癌症存在的结果是错误的。12种癌症占美国癌症死亡人数近三分之二的检测结果的敏感性为67.3%,这意味着该检测可以发现癌症三分之二的时间,但三分之一的时间检测结果为阴性。在该组中,I期癌症患者的敏感性为39%,II期患者为69%,III期患者为83%,IV期患者为92%。所有50种癌症类型的I-III期敏感性为43.9%。当检测到癌症时,该测试能在90%以上的病例中的准确识别癌症起源的器官和组织。——这是确定如何诊断和管理疾病的关键信息。

“我们的结果表明,这种检测血液中游离细胞DNA的方法可以在疾病的几乎任何阶段检测到广泛的癌症类型,其特异性和敏感性接近于全民筛查水平,”奥克斯纳德说。“这项测试可以成为早期癌症检测临床试验的重要组成部分。”

奥克斯纳德说,如果这种检测方法得到广泛应用的话,即使早期检测出普通癌症的一个很小的百分比,也可能使许多病人得到更有效的治疗。

原始出处:

Liu MC, et al. 1Sensitive and specific multi-cancer detection and localization using methylation signatures in cell-free DNA. Annals of Oncology (2020). DOI: 10.1016/j.annonc.2020.02.011.

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    2020-04-02 Luyuxie_11
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    2020-04-01 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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CD36属于B类清道夫受体家族,是分子量为88KD的单链跨膜蛋白。CD36蛋白的早期研究主要集中在脂肪的代谢以及与动脉粥样硬化的相关方面。近年来科研工作者们发现CD36是一个多配基受体蛋白,其生物学功

Science Advances:对癌症递送纳米颗粒治疗的更佳方法是什么?

纳米颗粒为癌症治疗和诊断提供了独特的机遇和挑战。尤其在精确定位癌细胞方面,纳米颗粒改进了目前传统的癌症治疗方式,旨在减轻患者痛苦。

Nature:重磅!癌症诊断的新方式或将出现——血液微生物DNA读数

导读:随着新一代测序的出现,我们拥有前所未有的能力来研究肿瘤基因和宿主基因组以及生物体内存在的大量微生物。之前有研究证据表明,这些微生物可能赋予某些癌症易感性,也可能影响对治疗的反应。现在研究人员切换

BMJ:一文盘点营养、饮食与九种癌症的风险

近日,BMJ刊登了一篇文章《Diet, nutrition, and cancer risk: what do we know and what is the way forward?》,选取了有明确