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术后循环游离 DNA 对可切除肝细胞癌的预后价值。

The prognostic value of postoperative circulating cell-free DNA in operable hepatocellular carcinoma.

机构信息

Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Scand J Gastroenterol. 2020 Dec;55(12):1441-1446. doi: 10.1080/00365521.2020.1839127. Epub 2020 Oct 29.

Abstract

BACKGROUND

Tumor biomarkers are eagerly needed in monitoring the recurrence of operable hepatocellular carcinoma (HCC). Circulating cell-free DNA (cfDNA) is a promising noninvasive molecular biomarker for HCC. The current study aimed to evaluate the clinical significance of the postoperative cfDNA in operable HCC.

METHODS

This study enrolled 82 HCC patients from January 2018 to June 2019. All patients underwent liver surgery and were pathologically diagnosed with HCC. Postoperative blood samples were collected from each patient. A fluorometric dsDNA assay was used to measure the concentration of cfDNA. We explore the correlation between cfDNA and recurrence. Kaplan-Meier's curves were used to evaluate the recurrence-free survival (RFS). Univariate and multivariate Cox regression analyses were used for assessing the relative clinical variables in predicting recurrence.

RESULTS

Of the 82 HCC patients, 72 (87%) patients are male and the average age was 52.7 ± 12.8 years. The cfDNA-low and cfDNA-high groups had median recurrence times of 19.5 months and 14.0 months, respectively ( = .023). Multivariate analysis showed that postoperative cfDNA, tumour number and microvascular invasion ( < .050) were independent risk factors for recurrence in operable HCC.

CONCLUSIONS

Postoperative cfDNA is still a promising marker to predict prognosis in postoperative HCC patients although prospective and large multicenter clinical study is needed to further validate the relationship between cfDNA and HCC recurrence.

摘要

背景

在监测可手术治疗的肝细胞癌(HCC)的复发方面,肿瘤生物标志物是急需的。循环无细胞 DNA(cfDNA)是一种很有前途的 HCC 非侵入性分子生物标志物。本研究旨在评估可手术 HCC 术后 cfDNA 的临床意义。

方法

本研究纳入了 2018 年 1 月至 2019 年 6 月期间的 82 名 HCC 患者。所有患者均接受了肝切除术,且病理诊断为 HCC。从每位患者采集术后血样。采用荧光 dsDNA 测定法测量 cfDNA 的浓度。我们探讨了 cfDNA 与复发之间的相关性。Kaplan-Meier 曲线用于评估无复发生存(RFS)。单变量和多变量 Cox 回归分析用于评估预测复发的相对临床变量。

结果

82 名 HCC 患者中,72 名(87%)为男性,平均年龄为 52.7±12.8 岁。cfDNA 低和 cfDNA 高组的中位复发时间分别为 19.5 个月和 14.0 个月(=0.023)。多变量分析显示,术后 cfDNA、肿瘤数量和微血管侵犯(<0.050)是可手术 HCC 患者复发的独立危险因素。

结论

尽管需要前瞻性和大型多中心临床研究进一步验证 cfDNA 与 HCC 复发之间的关系,但术后 cfDNA 仍然是预测术后 HCC 患者预后的有前途的标志物。

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