Fan Yihui, Shi Minxin, Chen Saihua, Ju Guanjun, Chen Lingxiang, Lu Haimin, Chen Jian, Zheng Shiying
Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow University, 215006 Suzhou, Jiangsu Province, China.
Department of Thoracic Surgery, The Affiliated Tumor Hospital of Nantong University, 226019 Nantong, Jiangsu Province, China.
Cell Mol Biol (Noisy-le-grand). 2019 Jul 31;65(6):56-63.
The content and integrity of cell-free DNA (cfDNA) before and after surgery in patients with lung cancer were determined to investigate its clinical significance. Peripheral blood was collected from 120 patients with lung cancer who were treated in our hospital from March 2016 to November 2018, including 50 cases before operation and 70 cases after operation. 60 healthy subjects served as controls. Quantitative PCR was used to determine the cfDNA level of each group. The relationship between cfDNA levels and the clinical features of lung cancer patients was determined. Receiver Operating Curves were used to determine the sensitivity and specificity of cfDNA, CEA, NSE and CYFRA21-1 in lung cancer. The concentration and integrity of cfDNA before surgery in patients with lung cancer were significantly higher than those after surgery and those in healthy control group. The cfDNA concentration in patients with lung cancer after surgery was significantly higher than that in the control group, but there was no statistical difference in cfDNA integrity between the two groups. There was no significant correlation between cfDNA concentration/integrity and gender, age, tumor type, tumor stage, and expressions of CA199, CA125, and CA153 in patients with lung cancer before or after surgery. However, there were significant correlations between the expression levels of CEA, NSE, and CYFRA21-1 and cfDNA concentration. The expression levels of CEA and CYFRA21-1 were significantly correlated with cfDNA integrity before surgery, while the correlations were not significant after surgery. The concentration and integrity of cfDNA increased significantly in serum of lung cancer patients. The concentration and integrity of cfDNA in patients with lung cancer after surgery were significantly lower than those before surgery. Thus, cfDNA has high application value in the diagnosis and evaluation of lung cancer.
为了探究无细胞DNA（cfDNA）在肺癌患者手术前后的含量及完整性，对其临床意义进行了研究。收集了2016年3月至2018年11月在我院接受治疗的120例肺癌患者的外周血，其中术前50例，术后70例。选取60名健康受试者作为对照。采用定量聚合酶链反应（PCR）测定各组的cfDNA水平。确定了cfDNA水平与肺癌患者临床特征之间的关系。采用受试者工作特征曲线（ROC）来确定cfDNA、癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和细胞角蛋白19片段（CYFRA21-1）在肺癌诊断中的敏感性和特异性。肺癌患者术前cfDNA的浓度和完整性显著高于术后及健康对照组。肺癌患者术后cfDNA浓度显著高于对照组，但两组cfDNA完整性差异无统计学意义。肺癌患者手术前后cfDNA浓度/完整性与性别、年龄、肿瘤类型、肿瘤分期以及糖类抗原199（CA199）、糖类抗原125（CA125）和糖类抗原153（CA153）的表达均无显著相关性。然而，CEA、NSE和CYFRA21-1的表达水平与cfDNA浓度显著相关。术前CEA和CYFRA21-1的表达水平与cfDNA完整性显著相关，而术后相关性不显著。肺癌患者血清中cfDNA的浓度和完整性显著升高。肺癌患者术后cfDNA的浓度和完整性显著低于术前。因此，cfDNA在肺癌的诊断和评估中具有较高的应用价值。
