Department of Breast Surgery, Cork University Hospital, Cork, Ireland; SURGUVANT Research Lab, University College Cork, Cork, Ireland.
SURGUVANT Research Lab, University College Cork, Cork, Ireland.
Surg Oncol. 2022 Jun;42:101753. doi: 10.1016/j.suronc.2022.101753. Epub 2022 Apr 3.
Circulating cell-free DNA (cfDNA) is a potential non-invasive biomarker of disease status in patients with cancer, and provides important diagnostic and prognostic information in breast cancer. The goal of this study was to quantify cfDNA concentrations during the perioperative period and investigate its potential utility to detect recurrence outcomes in patients with breast cancer.
Sixty-two (n = 62) patients with non-metastatic breast cancer, undergoing curative-intent surgery were screened for inclusion. Blood samples were collected from these patients: pre-operatively (Preop) and post-operatively (PO) at either of the following PO time points; PO week 1-2, PO week 3-4 and PO weeks 5-12 following surgery. cfDNA was extracted and quantified using nanodrop spectrophotometer.
In a cohort of 62 patients (age, median (IQR), 51.5(45.0-65.0) years), with a median follow-up of 90 months (interquartile range (IQR),60-120 months), significant association was observed between cfDNA concentrations and risk of recurrence in patients with breast cancer. The group of patients who had disease recurrence during follow-up had significantly higher cfDNA concentrations (cutoff:400 ng/ml) compared to the group of patients who remain disease-free (Preop and PO period: p < 0.0001). The median Recurrence Free Survival (RFS) between the Disease Recurrence (DR) and the Disease Free (DF) groups of patients with breast cancer were 12(20-28.5) months and 72.00 (96-120) months; p < 0.0001). Univariate and multivariate cox regression analysis indicated that postoperative cfDNA concentration (Hazard ratio:5.0, 95% Confidence Interval:1.19-21.28, p = 0.028) was an independent negative prognostic factor for RFS in patients with non-metastatic breast cancer.
Our study demonstrated that high postoperative cfDNA is associated with increased risk of future recurrence in patients with non-metastatic breast cancer. Further, prospective studies are warranted to validate its clinical utility in breast cancer.
循环无细胞 DNA（cfDNA）是癌症患者疾病状态的一种潜在非侵入性生物标志物，可为乳腺癌提供重要的诊断和预后信息。本研究的目的是量化围手术期 cfDNA 浓度，并研究其在乳腺癌患者中检测复发结果的潜在用途。
筛选了 62 名接受根治性手术的非转移性乳腺癌患者入组。从这些患者中采集血液样本：术前（Preop）和术后（PO），在以下 PO 时间点中的任意一个采集；PO 第 1-2 周、PO 第 3-4 周和 PO 第 5-12 周。使用纳米分光光度计提取和定量 cfDNA。
在 62 名患者（年龄中位数（IQR），51.5（45.0-65.0）岁）的队列中，中位随访时间为 90 个月（四分位距（IQR），60-120 个月），观察到 cfDNA 浓度与乳腺癌患者复发风险之间存在显著相关性。在随访期间发生疾病复发的患者组 cfDNA 浓度显著升高（cutoff：400ng/ml），与无疾病患者组相比（Preop 和 PO 期：p<0.0001）。乳腺癌患者疾病复发（DR）和疾病无复发生存（DF）组之间的中位无复发生存期（RFS）分别为 12（20-28.5）个月和 72.00（96-120）个月；p<0.0001）。单因素和多因素 Cox 回归分析表明，术后 cfDNA 浓度（危险比：5.0，95%置信区间：1.19-21.28，p=0.028）是无转移性乳腺癌患者 RFS 的独立负预后因素。
我们的研究表明，高术后 cfDNA 与非转移性乳腺癌患者未来复发风险增加相关。此外，需要进行前瞻性研究来验证其在乳腺癌中的临床应用价值。
