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肿瘤组织和循环肿瘤 DNA 中的异质性突变模式需要平行进行 NGS panel 检测。

Heterogeneous mutation pattern in tumor tissue and circulating tumor DNA warrants parallel NGS panel testing.

机构信息

Department of Laboratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

State Key Laboratory of Cell Biology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, 320 Yueyang Road, Shanghai, 200031, China.

出版信息

Mol Cancer. 2018 Aug 28;17(1):131. doi: 10.1186/s12943-018-0875-0.

Abstract

Liquid biopsy by genotyping circulating tumor DNA (ctDNA) has provided a non-invasive approach in assessing tumor genomic alterations in clinical oncology. However, emerging evidence in clinical settings has shown significant discordance in the genomic alterations between matched tumor tissue and blood ctDNA samples, and even between the same set of blood samples analyzed on different testing platforms. Thus, it is necessary to study underlying causes of discrepancies in these studies by genotyping tumor tissue and ctDNA in parallel using next generation sequencing (NGS) panels based on the same technology. Here we enrolled 56 non-small-cell lung cancer (NSCLC) patients and evaluated tumor tissue genotyping and ctDNA based liquid biopsy by parallel NGS panel testing and compared different sample preparation conditions. Somatic mutations in plasma cell-free DNA (cfDNA) were detected in 63.6% patients with early-stage NSCLC and 60% patients with advanced-stage NSCLC. The overall concordance between matched formalin-fixed paraffin-embedded sample and cfDNA was 54.6% in early-stage NSCLC patients and 80% in advanced-stage NSCLC patients. The positive concordance rate was 44.4% and 71.4% in early-stage and advanced-stage patients, respectively. Using fresh frozen tumor samples did not improve the overall concordance rate between matched tumor tissue and cfDNA. Processing blood samples beyond 4 h after blood draw significantly decreased the detection rate of somatic mutations in cfDNA. Thus, the concordance rate between tumor tissue-based and ctDNA-based genotyping in clinical samples can be affected by multiple pre-analytical, analytical and biologic factors. Parallel NGS panel testing on both sample types for each patient may be warranted for effective guidance of cancer targeted therapies and possible early detection of cancer.

摘要

液体活检通过基因分型循环肿瘤 DNA(ctDNA)为评估临床肿瘤学中的肿瘤基因组改变提供了一种非侵入性方法。然而,临床环境中的新证据表明,在匹配的肿瘤组织和血液 ctDNA 样本之间,甚至在不同检测平台分析的同一组血液样本之间,基因组改变存在显著差异。因此,有必要通过使用基于相同技术的下一代测序(NGS)面板对肿瘤组织和 ctDNA 进行平行基因分型,研究这些研究中差异的潜在原因。在这里,我们招募了 56 名非小细胞肺癌(NSCLC)患者,并行 NGS 面板检测评估了肿瘤组织基因分型和基于 ctDNA 的液体活检,并比较了不同的样本制备条件。在早期 NSCLC 患者和晚期 NSCLC 患者中,分别有 63.6%和 60%的患者检测到血浆无细胞 DNA(cfDNA)中的体细胞突变。在早期 NSCLC 患者中,匹配的福尔马林固定石蜡包埋样本和 cfDNA 之间的总体一致性为 54.6%,在晚期 NSCLC 患者中为 80%。在早期和晚期患者中,阳性一致性率分别为 44.4%和 71.4%。使用新鲜冷冻肿瘤样本并不能提高匹配的肿瘤组织和 cfDNA 之间的总体一致性。采血后超过 4 小时处理血液样本会显著降低 cfDNA 中体细胞突变的检测率。因此,临床样本中基于肿瘤组织和 ctDNA 的基因分型之间的一致性可能会受到多种分析前、分析和生物学因素的影响。可能需要对每个患者的两种样本类型进行平行 NGS 面板检测,以有效指导癌症靶向治疗并可能早期发现癌症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1987/6114875/0eb26ba0173b/12943_2018_875_Fig1_HTML.jpg

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