循环游离 DNA 水平对肝细胞癌的诊断价值。
Diagnostic value of circulating cell-free DNA levels for hepatocellular carcinoma.
机构信息
Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing 100034, China.
Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Jingshundongjie 8, Beijing 100015, China; Beijing Key Laboratory of Emerging Infectious Diseases, Beijing 100015, China; Genecast Precision Medicine Technology Institute, Huayuanbeilu 35, Beijing 100089, China.
出版信息
Int J Infect Dis. 2018 Feb;67:92-97. doi: 10.1016/j.ijid.2017.12.002. Epub 2017 Dec 8.
OBJECTIVES
Circulating cell-free DNA (cfDNA) is a potential biomarker for tumor diagnosis. Hepatocyte damage is a characteristic component of the pathobiology of hepatocellular carcinoma (HCC), which would be expected to result in substantial leakage of cfDNA into the circulation. However, the diagnostic value of cfDNA levels for HCC remains unclear.
METHODS
Plasma samples were collected from 24 HCC patients and 62 hepatitis B virus-related liver fibrosis patients. Plasma cfDNA levels were quantified by Qubit method.
RESULTS
Plasma cfDNA levels were associated with the degree of liver inflammation, body mass index, and alpha-fetoprotein (AFP) level, but were not associated with fibrosis stages. Plasma cfDNA levels were significantly higher in HCC patients than in non-HCC patients. Multivariate analysis revealed that age and cfDNA, rather than AFP, were independent predictors of HCC. The HCC index, a combination model including age, cfDNA, and AFP, had an area of 0.98 (95% confidence interval 0.92-1.00) under the receiver operating characteristics curve for the diagnosis of HCC at the cut-off value of 0.61, with 87.0% sensitivity and 100% specificity. The diagnostic power of the HCC index was superior to that of cfDNA alone and AFP alone.
CONCLUSIONS
These results suggest that the combination of cfDNA with age and AFP could improve the diagnostic performance for HCC.
目的
循环无细胞 DNA（cfDNA）是肿瘤诊断的潜在生物标志物。肝细胞损伤是肝细胞癌（HCC）病理生物学的一个特征性组成部分，预计会导致大量 cfDNA 渗漏到循环中。然而，cfDNA 水平对 HCC 的诊断价值仍不清楚。
方法
收集了 24 例 HCC 患者和 62 例乙型肝炎病毒相关肝纤维化患者的血浆样本。通过 Qubit 法定量血浆 cfDNA 水平。
结果
血浆 cfDNA 水平与肝脏炎症程度、体重指数和甲胎蛋白（AFP）水平相关，但与纤维化阶段无关。HCC 患者的血浆 cfDNA 水平明显高于非 HCC 患者。多变量分析显示，年龄和 cfDNA 而不是 AFP 是 HCC 的独立预测因子。HCC 指数是一个包含年龄、cfDNA 和 AFP 的组合模型，在截断值为 0.61 时，其在诊断 HCC 方面的曲线下面积为 0.98（95%置信区间 0.92-1.00），具有 87.0%的敏感性和 100%的特异性。HCC 指数的诊断能力优于单独的 cfDNA 和 AFP。
结论
这些结果表明，cfDNA 与年龄和 AFP 的结合可能会提高 HCC 的诊断性能。
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