CLIN CANCER RES:脑脊液游离循环肿瘤DNA测序诊断弥漫性胶质瘤

2018-06-30 MedSci MedSci原创

弥漫性胶质瘤是大脑最常见的原发肿瘤,有不同的亚型且不同亚型间预后差异明显。弥漫性胶质瘤的基因特征有助于其分子诊断。弥漫性胶质瘤的发生部位使得进行肿瘤活检难度很大,在某些病例中需要进行高风险的立体定向活检。最近,在颅内恶性肿瘤患者的脑脊液中发现了游离循环肿瘤DNA(ctDNA)。CLIN CANCER RES近期发表了一篇文章,利用脑脊液中的ctDNA诊断弥漫性胶质瘤。

弥漫性胶质瘤是大脑最常见的原发肿瘤,有不同的亚型且不同亚型间预后差异明显。弥漫性胶质瘤的基因特征有助于其分子诊断。弥漫性胶质瘤的发生部位使得进行肿瘤活检难度很大,在某些病例中需要进行高风险的立体定向活检。最近,在颅内恶性肿瘤患者的脑脊液中发现了游离循环肿瘤DNA(ctDNA)。CLIN CANCER RES近期发表了一篇文章,利用脑脊液中的ctDNA诊断弥漫性胶质瘤。

作者分析了TCGA数据库两个肿瘤队列的648例弥漫性胶质瘤的IDH1,IDH2,TP53,TERT,ATRX,H3F3A和HIST1H3B。还对胶质瘤患者的20个肿瘤和脑脊液标本进行ddPCR分析,对肿瘤进行组织病理分类。研究结果表明,分析648例弥漫性淋巴瘤患者的IDH1,IDH2,TP53,TERT,ATRX,H3F3A和HIST1H3B基因可以对79%的肿瘤进行分类,分类为IDH野生型胶质瘤,IDH突变胶质瘤/弥漫性星形细胞瘤和少突胶质细胞瘤,每一种亚型的中位总生存时间均不同(1.1,6.7和11.2年)。作者还建立了测序平台以快速的对脑脊液中ctDNA进行测序分析,从而对弥漫性胶质瘤进行分类。

文章最后认为,分析脑脊液中ctDNA的IDH1,IDH2,TP53,ATRX,TERT,H3F3A和HIST1H3B基因突变情况有助于弥漫性胶质瘤的诊断以及患者的临床管理

原始出处:
Francisco Mratinez-Ricarte,Regina Mayor,et al.Molecular Diagnosis of Diffuse Gliomas through Sequencing of Cell-Free Circulating Tumor DNA from Cerebrospinal Fluid.CLIN CANCER RES.June 2018 doi:10.1158/1078-0432.CCR-17-3800

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