Shyr Bor-Uei, Shyr Bor-Shiuan, Chen Shih-Chin, Chang Shih-Ching, Shyr Yi-Ming, Wang Shin-E
Department of Surgery, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan.
Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Cancers (Basel). 2021 May 12;13(10):2313. doi: 10.3390/cancers13102313.
Circulating cell-free DNA (cfDNA) in ampullary cancer patients was measured to clarify the correlation between cfDNA and clinicopathological factors and the impact of cfDNA on survival outcomes. Patients with ampullary cancer undergoing pancreaticoduodenectomy were included. Correlations between cfDNA and clinicopathological and prognostic factors were determined. The cfDNA levels in patients ranged from 1282 to 21,674 copies/mL, with a median of 6687 copies/mL. The cfDNA level was significantly higher in patients with lymph node involvement, lymphovascular invasion, abnormal serum carcinoembryonic antigen (CEA) level, and stage II and III cancer. Poor prognostic factors for ampullary cancer included high cfDNA > 6687 copies/mL, lymph node involvement, abnormal serum CEA > 5 ng/mL, and advanced stage II and III cancer. The 1- and 5-year survival rates were 92.0% and 66.5%, respectively, for patients with low cfDNA < 6687 copies/mL and 84.0% and 49.9%, respectively, for patients with high cfDNA > 6687 copies/mL ( < 0.001). After multivariate analysis, only the cfDNA level and stage were independent prognostic factors of ampullary cancer. Thus, the cfDNA level could act as a surrogate marker of both disease extent and biological aggressiveness of ampullary cancer. Moreover, cfDNA plays a significant role in the prognosis of resectable ampullary cancer.
测量壶腹癌患者循环游离DNA（cfDNA）水平，以阐明cfDNA与临床病理因素之间的相关性以及cfDNA对生存结局的影响。纳入接受胰十二指肠切除术的壶腹癌患者。确定cfDNA与临床病理及预后因素之间的相关性。患者的cfDNA水平在1282至21674拷贝/毫升之间，中位数为6687拷贝/毫升。在有淋巴结转移、淋巴管浸润、血清癌胚抗原（CEA）水平异常以及II期和III期癌症患者中，cfDNA水平显著更高。壶腹癌的不良预后因素包括cfDNA>6687拷贝/毫升、淋巴结转移、血清CEA>5 ng/mL以及II期和III期晚期癌症。cfDNA<6687拷贝/毫升的患者1年和5年生存率分别为92.0%和66.5%，cfDNA>6687拷贝/毫升的患者分别为84.0%和49.9%（<0.001）。多因素分析后，只有cfDNA水平和分期是壶腹癌的独立预后因素。因此，cfDNA水平可作为壶腹癌疾病范围和生物学侵袭性的替代标志物。此外，cfDNA在可切除壶腹癌的预后中起重要作用。
