Gastric Cancer: 肿瘤标志物和循环肿瘤DNA(ctDNA)在接受围手术期治疗的可切除胃癌患者中的预后价值

2021-11-03 MedSci原创 MedSci原创

20世纪中期,人们研究发现,细胞核内DNA并非一直隐藏在细胞核内,他们会到处溜达,游离在血液等体液中的DNA称为ctDNA。

在欧洲,局部胃癌患者的标准治疗方案包括切除D2淋巴结清扫联合围手术期化疗治疗。癌胚抗原 (CEA) 和糖类抗原19-9 (CA 19-9) 都是众所周知的肿瘤标志物,并且已经在大型荟萃分析中评估了它们在胃癌中的预后价值,即CEA或CA 19-9水平升高与总体生存 (OS) 和复发方面的较差结果相关。除了经典的血清学肿瘤标志物外,循环肿瘤 DNA (ctDNA) 最近已成为包括胃癌患者在内的各种肿瘤类型的潜在预后标志物。理想情况下,在关键的预处理时间点结合各种预后标志物将有助于临床决策并指导正在进行的治疗。本研究的目的是确定术前化疗开始前血红蛋白、中性粒细胞、碱性磷酸酶、乳酸脱氢酶、CEA和CA 19-9水平对胃癌患者的预后价值。

 

总共有788名患者接受了胃癌围手术期治疗。在单变量和多变量Cox回归分析中评估了胃癌患者存活率和CEA、CA 19-9、碱性磷酸酶、中性粒细胞、血红蛋白和乳酸脱氢酶之间的关联。对肿瘤标志物没有升高、肿瘤标志物之一升高对比两种肿瘤标志物升高的患者接受潜在治愈性手术的可能性进行了进一步调查。在具有可用 ctDNA数据的50名患者中探索了肿瘤标志物与循环肿瘤 DNA (ctDNA) 存在之间的关联。

 

本项研究结果证实在多变量分析中发现治疗前CEA升高(HR 1.43;95% CI 1.11-1.85,p  < 0.001)和CA 19-9(HR 1.79;95% CI 1.42-2.25,p  < 0.001) 与较差的OS相关。对于没有肿瘤标志物、CEA 或 CA 19-9 升高的患者,接受潜在治愈性手术的可能性分别为 86%、77% 和 60% ( p<0.001)。尽管术前 ctDNA 和肿瘤标志物的存在都是生存的预后因素,但未发现这两个参数之间存在关联。

 

本项研究发现CEA和 CA 19-9 是可切除胃癌患者生存的独立预后因素,但是研究人员未发现肿瘤标志物与ctDNA之间的关系。总的来说,ctDNA对于肿瘤的早期诊断、个体化治疗、监测病情、早期发现疾病复发都有重大意义,近些年来人们一直致力于如何有效利用该标志物帮助癌症诊断和监测。

原始出处:

Astrid E. Slagte. Et al. Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial.Gastric Cancer.2021.

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    2022-05-02 许安
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beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7851, encryptionId=4fc4e85161, topicName=gastric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9b30126, createdName=skhzy, createdTime=Thu Jul 28 18:35:34 CST 2022, time=2022-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712959, encodeId=ebc41e129595b, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Mon Jul 25 01:35:34 CST 2022, time=2022-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1841764, encodeId=6eee1841e6415, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Thu Feb 17 11:35:34 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385256, encodeId=edd11385256b4, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Nov 05 12:35:34 CST 2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484886, encodeId=2585148488629, content=<a href='/topic/show?id=35a050454a5' target=_blank style='color:#2F92EE;'>#循环肿瘤DNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50454, encryptionId=35a050454a5, topicName=循环肿瘤DNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac107986109, createdName=ms1948154235210413, createdTime=Fri Nov 05 12:35:34 CST 2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066917, encodeId=8d4d106691ea0, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4f75559630, createdName=hannah1001, createdTime=Thu Nov 04 13:31:28 CST 2021, time=2021-11-04, status=1, ipAttribution=)]
    2022-07-28 skhzy
  5. 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2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484886, encodeId=2585148488629, content=<a href='/topic/show?id=35a050454a5' target=_blank style='color:#2F92EE;'>#循环肿瘤DNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50454, encryptionId=35a050454a5, topicName=循环肿瘤DNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac107986109, createdName=ms1948154235210413, createdTime=Fri Nov 05 12:35:34 CST 2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066917, encodeId=8d4d106691ea0, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e4f75559630, createdName=hannah1001, createdTime=Thu Nov 04 13:31:28 CST 2021, time=2021-11-04, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1769709, encodeId=8c9b1e69709a8, content=<a href='/topic/show?id=900b8323461' target=_blank style='color:#2F92EE;'>#胃癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83234, encryptionId=900b8323461, topicName=胃癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=377c38086944, createdName=huhuaidong400, createdTime=Sat Jun 25 05:35:34 CST 2022, time=2022-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053927, encodeId=a48f205392ebc, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, 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encodeId=6eee1841e6415, content=<a href='/topic/show?id=18bf61953d3' target=_blank style='color:#2F92EE;'>#标志物#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61953, encryptionId=18bf61953d3, topicName=标志物)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Thu Feb 17 11:35:34 CST 2022, time=2022-02-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385256, encodeId=edd11385256b4, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Fri Nov 05 12:35:34 CST 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  7. 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2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484886, encodeId=2585148488629, content=<a href='/topic/show?id=35a050454a5' target=_blank style='color:#2F92EE;'>#循环肿瘤DNA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50454, encryptionId=35a050454a5, topicName=循环肿瘤DNA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac107986109, createdName=ms1948154235210413, createdTime=Fri Nov 05 12:35:34 CST 2021, time=2021-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1066917, encodeId=8d4d106691ea0, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, 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  8. 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    2021-11-04 hannah1001

    #学习#学习

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