外周血游离DNA含量和完整性的动态变化检测在胃癌诊治中的意义

李翔翔; 陈城; 王琳; 黄宝丽; 彭群新; 史进方

doi:10.3971/j.issn.1000-8578.2017.02.008

外周血游离DNA含量和完整性的动态变化检测在胃癌诊治中的意义

Significance of Content and Integrity Changes of Peripheral Blood Cell-free DNA in Diagnosis and Treatment in Gastric Cancer

摘要

摘要:
目的监测胃癌患者外周血游离DNA（cell-free DNA, cf-DNA）的含量，探讨其在胃癌诊治和预后中的价值。
方法收集81例原发胃癌、18例胃良性肿瘤、19例胃癌前病变、43例同期门诊健康体检者以及部分术后和随访的外周血标本，提取游离DNA，荧光定量PCR检测其含量（ALU115和ALU247）并计算完整性（ALU247/ALU115），分析血清游离DNA和血浆游离DNA含量之间的相关性。
结果血浆游离DNA含量和完整性在四组之间的差异有统计学意义（ALU115、ALU247以及完整性的P值均<0.001），术前术后的差异也有统计学意义（P值分别为0.000、0.013、0.010），随访前后完整性差异有统计学意义（P=0.029），在有无转移、分期、分化程度间差异有统计学意义（P值分别为0.013、0.042、0.003）。血浆和血清游离DNA含量具有相关性且血浆离散趋势更小。ALU247的ROC曲线下面积最高（0.985）。
结论游离DNA检测在胃癌的诊治和预后中有一定的价值。

Abstract:
Objective To explored the role and value in the diagnosis, treatment and prognosis in gastric cancer via monitoring the content of cell-free DNA(cf-DNA).
Methods we collected preoperative peripheral blood specimens from 81 cases of patients with primary gastric cancer, 18 cases gastric benign tumors, 19 cases gastric precancerous lesion, 43 cases of corresponding healthy controls. We also collected part of the postoperative and follow-up specimens. cf-DNA from specimens was extracted and used to detect the content and integrity of two DNA genes (ALU115 and ALU247) by fluorescence quantitative PCR. We compare the correlation of cf-DNA in serum and plasma.
Results The content and integrity of cf-DNA have statistically significant difference in four groups, in pre- and post- operation and follow-up specimens，in staging, differentiated degree and with or without metastasis (P<0.05). The content of cf-DNA in plasma and serum is relevant and the former has less discrete trend. The area under the curve (AUC) of ALU247 was 0.985.
Conclusion The test of cf-DNA has certain value in the diagnosis, treatment and prognosis of gastric cancer.

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