Varzaru Bianca, Iacob Razvan Andrei, Bunduc Stefania, Manea Ioana, Sorop Andrei, Spiridon Andreea, Chelaru Raluca, Croitoru Adina, Topala Mihaela, Becheanu Gabriel, Dumbrava Mona, Dima Simona, Popescu Irinel, Gheorghe Cristian
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Center of Excellence in Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Int J Mol Sci. 2024 Mar 1;25(5):2854. doi: 10.3390/ijms25052854.
Circulating cell-free DNA (ccfDNA) quantity correlates with the clinical characteristics and prognosis of various cancer types. We investigated whether ccfDNA levels and the neutrophil-to-lymphocyte ratio (NLR) have prognostic value in patients with pancreatic ductal adenocarcinoma (PDAC). Peripheral blood was collected from 82 patients with PDAC prior to any diagnostic procedure or the administration of chemotherapy. Plasma DNA was isolated, and ccfDNA concentration and NLR were determined. We found that ccfDNA levels were correlated with age and tumor burden. Moreover, higher values of NLR (≥3.31) were linked with worse overall survival (OS) (4 vs. 10 months; log rank = 0.011), and an elevated ccfDNA concentration (≥25.79 ng/mL) was strongly associated with shorter OS (4 vs. 8 months; log rank = 0.009). According to the results of the multivariable Cox regression analysis, the baseline concentration of ccfDNA was an independent prognostic factor for OS (HR 0.45, 95% CI 0.21-0.97, = 0.041). Furthermore, the combination of ccfDNA levels with NLR greatly enhanced the prognostic accuracy of PDAC patients. Our study demonstrates that ccfDNA concentration and NLR are independent predictors of survival in PDAC. Subsequent studies should validate this combination as a prognostic indicator in PDAC patients and assess its utility for guiding therapeutic decisions.
循环游离DNA（ccfDNA）的量与多种癌症类型的临床特征和预后相关。我们研究了ccfDNA水平和中性粒细胞与淋巴细胞比值（NLR）在胰腺导管腺癌（PDAC）患者中是否具有预后价值。在任何诊断程序或化疗给药之前，从82例PDAC患者中采集外周血。分离血浆DNA，并测定ccfDNA浓度和NLR。我们发现ccfDNA水平与年龄和肿瘤负荷相关。此外，较高的NLR值（≥3.31）与较差的总生存期（OS）相关（4个月对10个月；对数秩检验=0.011），而ccfDNA浓度升高（≥25.79 ng/mL）与较短的OS密切相关（4个月对8个月；对数秩检验=0.009）。根据多变量Cox回归分析结果，ccfDNA的基线浓度是OS的独立预后因素（风险比0.45，95%置信区间0.21-0.97，P=0.041）。此外，ccfDNA水平与NLR的联合显著提高了PDAC患者的预后准确性。我们的研究表明，ccfDNA浓度和NLR是PDAC患者生存的独立预测因素。后续研究应验证这种联合作为PDAC患者预后指标的有效性，并评估其在指导治疗决策中的效用。
