一个无细胞DNA基于血液的测试用于结肠直肠癌查
Daniel C Chung1, Darrell M Gray1, Harminder Singh1
1From the Division of Gastroenterology and Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston (D.C.C.); Gray Area Strategies, Owings Mills, MD (D.M.G.); the Association of Black Gastroenterologists and Hepatologists, New York (D.M.G.); the Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba and Paul Albrechtsen Research Institute CancerCare Manitoba, Winnipeg, Canada (H.S.); the Divisions of Public Health Sciences (R.B.I., W.M.G.), Clinical Research (R.B.I.), and Translational Science and Therapeutics (W.M.G.), Fred Hutchinson Cancer Center, and the Division of Gastroenterology, University of Washington School of Medicine (R.B.I., W.M.G.) - both in Seattle; Guardant Health, Palo Alto (V.M.R., C.E., S.H., D.I.C., A.T.), and the University of California, San Diego, La Jolla (S.G.) - both in California; the Department of Pathology, Michigan Medicine, Ann Arbor (J.K.G.); and the Divisions of Oncology, Gastroenterology, and Hepatology, Mayo Clinic, Mayo Comprehensive Cancer Center and Mayo Alix School of Medicine, Rochester, MN (F.A.S.).
一项新的血液测试显示了结直肠癌查的前景,检测了83%的癌症和90%的晚期瘤. 这种无细胞DNA (cfDNA) 测试可以提高这种常见癌症的坚持性和早期检测率.
科学领域:
- 在瘤学瘤学.
- 分子诊断学 分子诊断
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌是美国癌症死亡的主要原因之一.
- 尽管有可用的测试,但查率仍然很低.
- 基于血液的测试有可能改善查遵守率和早期检测.
研究的目的:
- 为了评估无细胞DNA (cfDNA) 血液测试用于结直肠癌查的性能.
- 为了确定对结直肠癌的敏感性和对晚期瘤的特异性.
- 为了评估检测晚期癌前病变的敏感性.
主要方法:
- 一项临床验证研究涉及10,258名符合结直肠癌查条件的参与者.
- 将cfDNA血液检测结果与查结肠镜检测结果进行比较.
- 对副初级结果的分析:对结直肠癌的敏感性和对晚期瘤的特异性.
主要成果:
- 该cfDNA测试显示,检测结直肠癌的灵敏度为83.1%.
- 晚期瘤的特异性为89.6%.
- 对晚期癌前病变的敏感度为13.2%.
结论:
- 在平均风险人群中,cfDNA血液测试实现了对结直肠癌的83%敏感性和对晚期瘤的90%特异性.
- 该测试有可能提高结肠直肠癌查的遵守率并降低死亡率.
- 进一步的验证支持cfDNA测试在结直肠癌查策略中的作用.


