循环瘤DNA和MRI环切割边缘是直肠癌生存的关键预后指标
A Roy1,2, M Shepherdson2,3, K Gormly4,5
1Department of Oncology, Flinders Centre For Innovation In Cancer, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park.
ESMO gastrointestinal oncology
|February 6, 2026
概括
在治疗前检测到的甲基化循环瘤DNA (ctDNA),结合正环切除边缘 (CRM+),强烈预测直肠癌患者的生存率不佳. 这种综合标志物是预后不佳的重要独立预测因素.
科学领域:
- 在瘤学瘤学.
- 分子诊断学 分子诊断学
- 放射学 放射学是一门学科.
背景情况:
- 结直肠癌复发与手术后甲基化循环瘤DNA (ctDNA) 有关.
- 在直肠癌中预治疗ctDNA的预后价值尚不清楚.
- 像MRI这样的放射性标记物用于直肠癌的预后.
研究的目的:
- 调查前期治疗ctDNA和MRI预后标记在直肠癌中的相关性.
- 评估治疗前ctDNA和MRI标记与无复发生存率和整体生存率 (OS) 的相关性.
主要方法:
- 42名直肠癌患者在诊断时接受了分期MRI和血液ctDNA分析 (BCAT1/IKZF1甲基化).
- 奇平方测试评估了MRI指标和ctDNA结果之间的相关性.
- 单变量和多变量考克斯回归分析确定了无复发生存和OS的预测因素.
主要成果:
- 67%的患者在诊断时对甲基化ctDNA呈阳性.
- 周围切除边缘阳性 (CRM+) 患者主要具有阳性ctDNA.
- 多变量分析确定CRM+/ctDNA+是低生存率的独立预测因素 (HR 19.57).
结论:
- 在直肠癌中,CRM参与往往与ctDNA阳性相吻合,导致最差的预后.
- 在治疗前后进行纵向ctDNA评估可以完善预后并个性化治疗策略.
- 结合ctDNA和CRM状态是直肠癌的强有力的预后指标.
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