切除可能なおよび切除可能な管腺がんにおける隠された転移を予測する術前循環腫瘍DNAの役割
Takeshi Murakami1, Masafumi Imamura2, Yasutoshi Kimura1
1Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo 060-0061, Hokkaidō, Japan.
World journal of gastroenterology
|September 3, 2025
まとめ
術前循環中の腫瘍DNA (ctDNA) は,臓管内腺がん (PDAC) の患者の隠れた転移を予測することができます. このバイオマーカーは手術後の予後が悪いことを示し,治療決定に役立ちます.
科学分野:
- 腫瘍学
- 分子診断
- 手術腫瘍学
背景:
- 管腺がん (PDAC) の患者は,未検出の遠隔転移 (オークルト転移,OMs) があり,手術後の早期再発を引き起こす可能性があります.
- OMの正確な予測は,切除可能なPDACの多分野治療戦略を最適化するために不可欠です.
研究 の 目的:
- 循環中の腫瘍DNA (ctDNA) が,臓管内腺がん患者の隠れた転移を予測するバイオマーカーとしての有効性を評価する.
主な方法:
- 日本の2つの機関で135人のPDAC患者からの術前プラズマサンプル収集 (2019年7月 - 2021年9月).
- 52のがん関連遺伝子を対象とした次世代配列化パネルを用いたctDNAの分析
主要な成果:
- 135人のPDAC患者のうち38人が隠れた転移 (OM) を有していた.
- ctDNAの陽性性は,OMのない患者と比較して有意に高かった.
- ctDNA陽性は独立してOMを予測し,再発のない生存期間が短かった.
結論:
- 術前のctDNAは,切除可能なPDACにおける隠された転移の独立した予測因子である.
- ctDNAの陽性は 臓切除術後の予後が悪いことを示します
- ctDNAは,PDACにおける多学科的患者ケアを導くための貴重なバイオマーカーとして機能する.
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