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循环游离DNA与癌胚抗原在结直肠癌疗效评估中的比较研究

Investigation of Efficacy Evaluation Comparison of cfDNA and CEA in Colorectal Cancer.

作者信息

Yu Dan, An GuangYu, Xu LingLing

出版信息

Clin Lab. 2016 Oct 1;62(10):1947-1953. doi: 10.7754/Clin.Lab.2016.160215.

DOI:10.7754/Clin.Lab.2016.160215
PMID:28164530
Abstract

BACKGROUND

To investigate the comparison of efficacy evaluation value for cell-free DNA (cfDNA) and CEA in advanced colorectal cancer.

METHODS

A total of 40 patients with advanced colorectal cancer were enrolled in this study. By PCR Real-time, changes of plasma ALU247and ALU115 level as well as the cfDNA integrity (ALU247/ALU115) before and after chemotherapy were analyzed in patients with advanced colorectal cancer. Meanwhile, changes of CEA before and after chemotherapy were monitored to compare the efficacy evaluation value of cfDNA and the conventional CEA in the treatment of advanced colorectal cancer.

RESULTS

After first-line chemotherapy, levels of ALU247, ALU115, and ALU247/ALU115 were significantly decreased (p < 0.05) in the respond groups from that of baseline, the same for CEA (p < 0.05). Levels of ALU115 and ALU247 and ALU247/ALU115 (p > 0.05) as well as CEA (p > 0.05) were not changed in stable groups compared with the baseline. In the progression group, however, levels of ALU247 and ALU247/ALU115 were significantly higher than baseline (p < 0.05), and CEA was also higher than that of baseline, but without statistical significance (p > 0.05). ROC curves showed that cfDNA integrity (ALU247/115) and CEA could be used as powerful indicators of outcome assessment.

CONCLUSIONS

Both cfDNA and CEA are closely related to the evaluation of the first-line chemotherapy for advanced colorectal cancer. The level and integrity of cfDNA are expected to be sensitive indicators for monitoring the efficacy of colorectal neoplasm treatment and earlier clues for tumor progression than CEA.

摘要

背景

探讨游离DNA(cfDNA)与癌胚抗原(CEA)在晚期结直肠癌疗效评估价值方面的比较。

方法

本研究共纳入40例晚期结直肠癌患者。采用实时荧光定量聚合酶链反应(PCR)分析晚期结直肠癌患者化疗前后血浆ALU247和ALU115水平以及cfDNA完整性(ALU247/ALU115)的变化。同时,监测化疗前后CEA的变化,以比较cfDNA与传统CEA在晚期结直肠癌治疗中的疗效评估价值。

结果

一线化疗后,缓解组中ALU247、ALU115及ALU247/ALU115水平较基线水平显著降低(p<0.05),CEA水平亦是如此(p<0.05)。稳定组中,与基线相比,ALU115、ALU247及ALU247/ALU115水平(p>0.05)以及CEA水平(p>0.05)均未发生变化。然而,在进展组中,ALU247及ALU247/ALU115水平显著高于基线(p<0.05),CEA水平亦高于基线,但无统计学意义(p>0.05)。ROC曲线显示,cfDNA完整性(ALU247/115)和CEA可作为疗效评估的有力指标。

结论

cfDNA和CEA均与晚期结直肠癌一线化疗的评估密切相关。cfDNA的水平和完整性有望成为监测结直肠癌治疗疗效的敏感指标,且比CEA更早提示肿瘤进展。

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