Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
Department of Dermatology, Wakayama Medical University, Wakayama, Japan.
Br J Dermatol. 2019 Sep;181(3):505-511. doi: 10.1111/bjd.17709. Epub 2019 Apr 7.
Although carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) are useful markers for extramammary Paget disease (EMPD), serum CEA and CYFRA levels are not elevated in most patients with EMPD without metastasis. Cell-free (cf)DNA has attracted attention as an indicator of clinical conditions in several cancers.
To identify further useful biomarkers for the detection of EMPD, including early lesions, and to study the clinical implications of cfDNA in EMPD.
cfDNA were isolated from serum of patients with EMPD with and without metastasis, and from healthy volunteers. Serum extracts were amplified using polymerase chain reaction.
Serum cfDNA levels were significantly elevated in patients with EMPD with or without metastasis compared with those in healthy controls. Serum cfDNA was a better diagnostic marker for the presence of EMPD than serum CYFRA. Moreover, the postoperative serum cfDNA levels were significantly lower than those from the preoperative samples, and the change in serum cfDNA levels reflected the clinical courses of patients with EMPD treated with chemotherapy.
Taking the evidence together, serum cfDNA levels may be a useful marker for diagnosis and disease progression in EMPD. What's already known about this topic? Serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) are not elevated in most patients with extramammary Paget disease (EMPD) without metastasis. Cell-free (cf)DNA has attracted attention as an indicator of clinical conditions in several cancers. There are few reports of the clinical implications of cfDNA in dermatology. What does this study add? Serum cfDNA levels were significantly elevated in patients with EMPD with or without metastasis compared with those in healthy controls. Postoperative serum cfDNA levels were significantly lower than those from the preoperative samples. Changes in serum cfDNA levels reflected the clinical courses of patients with EMPD treated with chemotherapy. What is the translational message? Serum cfDNA levels in patients with EMPD are a useful marker for the detection of EMPD, including localized EMPD. Changes in serum cfDNA levels in an individual patient may reflect the clinical course of EMPD.
癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA）虽然是乳房外派杰病（EMPD）的有用标志物，但大多数无转移的 EMPD 患者的血清 CEA 和 CYFRA 水平并未升高。游离细胞（cf）DNA 作为几种癌症临床状况的指标引起了人们的关注。
寻找更多用于检测 EMPD（包括早期病变）的有用生物标志物，并研究 cfDNA 在 EMPD 中的临床意义。
从有或无转移的 EMPD 患者和健康志愿者的血清中分离 cfDNA。使用聚合酶链反应对血清提取物进行扩增。
与健康对照组相比，有或无转移的 EMPD 患者的血清 cfDNA 水平显著升高。血清 cfDNA 是诊断 EMPD 的标志物，优于血清 CYFRA。此外，术后血清 cfDNA 水平明显低于术前样本，血清 cfDNA 水平的变化反映了接受化疗的 EMPD 患者的临床病程。
综合来看，血清 cfDNA 水平可能是 EMPD 诊断和疾病进展的有用标志物。
血清癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA）水平在大多数无转移的乳房外派杰病（EMPD）患者中并未升高。游离（cf）DNA 作为几种癌症临床状况的指标引起了人们的关注。关于 cfDNA 在皮肤病学中的临床意义的报道很少。本研究增加了哪些内容？与健康对照组相比，有或无转移的 EMPD 患者的血清 cfDNA 水平显著升高。术后血清 cfDNA 水平明显低于术前样本。血清 cfDNA 水平的变化反映了接受化疗的 EMPD 患者的临床病程。
这有什么转化意义？EMPD 患者的血清 cfDNA 水平是检测 EMPD（包括局限性 EMPD）的有用标志物。个体患者的血清 cfDNA 水平变化可能反映 EMPD 的临床病程。
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