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循环瘤DNA检测改善了上皮卵巢癌复发的预测

Ying Zhang¹, Yanfang Guan^2,3, Xiao Xiao⁴

¹Department of Obstetrics and Gynecology, National Clinical Research Centre for Obstetric and Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

|December 22, 2024

概括

在手术后通过循环瘤DNA (ctDNA) 检测分子残留疾病 (MRD) 比CA125更好地预测上皮卵巢癌 (EOC) 复发. 基线ctDNA可以指导EOC患者的监测策略.

科学领域:

妇科瘤学妇科瘤学
分子诊断学分子诊断
癌症基因组学癌症基因组学

背景情况:

表皮卵巢癌 (EOC) 是一种致命的妇科恶性瘤,在治疗后经常复发.
循环瘤DNA (ctDNA) 对检测分子残留疾病 (MRD) 和预测EOC复发具有前途.
关于ctDNA在EOC中检测MRD的实用性存在有限的研究.

研究的目的:

评估基于ctDNA的MRD检测对于预测EOC患者手术后和化疗后复发的疗效.
将手术后MRD的预后值与CA125.5进行比较.
探索基线和化疗后ctDNA在风险分层和监测中的作用.

主要方法:

招募了51名接受初级脱手术 (PDS) 和辅助化疗 (ACT) 的EOC患者.
在瘤和血样本上对1021个癌症基因进行了向测序和Enrich-rare-mutation测序.
在PDS之前,PDS之后和ACT后评估ctDNA水平以检测MRD.

主要成果:

手术后MRD检测与复发 (Log-rank p=0.0006) 和一个独立的预后因素 (HR=3.4,p=0.047) 有显著的关联.
与CA125相比,手术后MRD的复发预测值优于CA125,负和正预测值分别为0.83和0.62.
整合ctDNA和CA125改善了风险分层;ACT后MRD确定了具有ctDNA清除的高风险患者,以及基线ctDNA的监测决策.

结论:

通过ctDNA进行手术后MRD检测比CA125.5更准确地预测EOC复发.
在ACT后过渡性ctDNA清除的患者可能仍然存在风险,需要纵向监测.
基线ctDNA评估可以指导进行手术后ctDNA监测的决定.

关键词:

CA125 CA125 CA125 CA125 是一家在美国的公司.循环瘤DNA是循环中的瘤DNA.卵巢上皮癌是卵巢癌的表皮癌.分子残留疾病分子残留疾病复发复发的情况

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