在手术治疗的HNSCC患者中检测残留疾病和复发的个性化ctDNA分析
Susanne Flach1,2,3, Christodoulos Pipinikas4, Tom Huberty5
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, LMU Munich, Munich, Germany. susanne.flach@med.uni-muenchen.de.
NPJ precision oncology
|February 3, 2026
概括
监测脑和部状细胞癌 (HNSCC) 患者的循环瘤DNA (ctDNA) 可以早期检测复发. 这种血液检测显示出指导治疗和改善HNSCC.结果的希望.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 基因组学就是基因组学.
背景情况:
- 尽管采用多式疗法,头皮状细胞癌 (HNSCC) 的存活率仍有有限的改善.
- 早期检测分子残留疾病 (MRD) 和复发对于有效的HNSCC管理至关重要.
研究的目的:
- 评估基于瘤的循环瘤DNA (ctDNA) 测定对早期检测MRD和HNSCC患者复发的有用性.
- 为了将手术前的ctDNA脱落与HNSCC.HNSCC的病理和分子特征相关联.
- 评估串行ctDNA监测的性能,以预测治疗意图手术后复发的情况.
主要方法:
- 在手术前和手术后,分别从76名和54名HNSCC患者的血和唾液中对ctDNA的纵向分析.
- 术前ctDNA水平与病态阶段,淋巴结参与,组织学特征,PD-1表达和瘤突变负担的相关性.
- 转录形状分析以确定具有高ctDNA流失的分子关联.
- 对血ctDNA进行评估,以检测术后的复发情况,并进行引导时间分析.
主要成果:
- 高度的手术前ctDNA流失与晚期病理阶段,淋巴结转移,不良组织学和特定的分子标记物 (PD-1,高瘤突变负担) 有关.
- 转录基因分析将高ctDNA流失与增加的增殖,激活的EGFR/MAPK信号传递,以及上调的入侵/转移基因联系起来.
- 在手术后≥14天检测到的血ctDNA发现了91.3%的复发,临床诊断前的预先时间高达500天.
结论:
- 序列ctDNA监测是早期检测HNSCC患者复发的宝贵工具.
- ctDNA分析可以为复发检测提供显著的领先时间,从而有可能实现更早的干预.
- 这些发现支持将ctDNA监测纳入HNSCC后续策略,以改善患者管理和结果.
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