From the Department of Surgery, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.
Pancreas. 2021 Feb 1;50(2):214-218. doi: 10.1097/MPA.0000000000001730.
Circulating cell-free DNA (cfDNA) analysis is recently reported as a promising prognostic biomarker in various types of cancer. This study aimed to evaluate the role of cfDNA in pancreatic head adenocarcinoma.
Data for pancreatic head adenocarcinoma undergoing pancreaticoduodenectomy were studied for cfDNA. Prognostic factors were determined, and their correlation with cfDNA level was evaluated.
The median of cfDNA for 97 cases was 7724 copies/mL, with a mean of 10,467, and ranging from 1856 to 44,203. Cell-free DNA was significantly higher in positive lymph node involvement and advanced stage III. Poor prognostic factors included high cfDNA level (>7724 copies/mL), abnormal carbohydrate antigen 19-9, abnormal carcinoembryonic antigen, and advanced stage. The 1- and 5-year survivals for those with high cfDNA were poorer, 70.2% and 21.2%, respectively, as compared with 93.4% and 23.7% for those with low cfDNA level. Only cfDNA level and stage were independent prognostic factors after multivariate analysis.
The level of cfDNA was correlated with tumor burden. Therefore, it could be an emerging survival predictor for resectable pancreatic head adenocarcinoma, and its detection might be a promising liquid biopsy to monitor both tumor progression and treatment response.
循环游离 DNA（cfDNA）分析最近被报道为各种类型癌症有前途的预后生物标志物。本研究旨在评估 cfDNA 在胰头腺癌中的作用。
研究了接受胰十二指肠切除术的胰头腺癌患者的 cfDNA 数据。确定了预后因素，并评估了它们与 cfDNA 水平的相关性。
97 例患者的 cfDNA 中位数为 7724 拷贝/ml，平均值为 10467，范围为 1856 至 44203。cfDNA 在阳性淋巴结受累和晚期 III 期时显著升高。不良预后因素包括高 cfDNA 水平（>7724 拷贝/ml）、异常糖类抗原 19-9、异常癌胚抗原和晚期。高 cfDNA 组的 1 年和 5 年生存率分别为 70.2%和 21.2%，而低 cfDNA 组分别为 93.4%和 23.7%。只有 cfDNA 水平和分期是多因素分析后的独立预后因素。
cfDNA 水平与肿瘤负荷相关。因此，它可能是一种新兴的可切除胰头腺癌生存预测指标，其检测可能是监测肿瘤进展和治疗反应的有前途的液体活检方法。
