可手术的非小细胞肺癌患者外周静脉血cfDNA总浓度及长片段DNA浓度的临床价值研究
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摘要
目的探讨定量检测可手术的非小细胞肺癌患者外周血cfDNA总浓度及长片段DNA浓度的临床价值。方法选择2017年1月～12月承德市中心医院胸外科60例可手术的非小细胞肺癌患者为实验组,分别于手术前1 d、手术后7 d、手术后20 d采集外周静脉血液标本,同期于承德市中心医院体检中心选择60例健康体检者为对照组,采集外周静脉血液标本,定量检测两组标本血液中cfDNA总浓度及长片段DNA浓度,进行统计学分析。结果实验组患者手术前1 d外周静脉血中cfDNA总浓度较对照组升高,差异具有统计学意义(P<0.05);实验组患者术后7 d外周静脉血中cfDNA总浓度较术前1 d无明显变化,差异无统计学意义(P>0.05);实验组患者术后20 d外周静脉血中cfDNA总浓度较术前1 d、术后7 d降低,差异均有统计学意义(P<0.05)。实验组患者手术前1 d外周静脉血中长片段DNA浓度高于对照组,差异具有统计学意义(P<0.05);实验组患者术后7 d外周静脉血中长片段DNA浓度较术前1 d无明显变化,差异无统计学意义(P>0.05);实验组患者术后20 d外周静脉血中长片段DNA浓度较术前1 d、术后7 d降低,差异均有统计学意义(P<0.05)。结论外周静脉血cfDNA总浓度及长片段DNA浓度可间接反映非小细胞肺癌患者肿瘤负荷状况,有望成为非小细胞肺癌辅助诊断、疗效评估及预后判断的参考指标。
Objective To investigate the clinical value of quantitative detection of total cfDNA concentration and long DNA concentration in peripheral blood of patients with operable non-small cell lung cancer. Methods From January to December 2017, 60 patients with operable non-small cell lung cancer in the Department of Thoracic Surgery, Chengde Central Hospital were selected as experimental group. Peripheral venous blood samples were collected 1 d before surgery, 7 d after surgery and 20 d after surgery. In the same period, 60 healthy people in the physical examination center of Chengde Central Hospital were selected as the control group. Peripheral venous blood samples were collected, and the total concentration of cfDNA and long DNA concentration in the blood of the two groups were quantitatively analyzed for statistical analysis. Results The total concentration of cfDNA in peripheral vein blood in the experimental group was significantly higher than that in the control group one day before operation,the difference was statistically significant(P<0.05),There was no significant change in the total concentration of cfDNA in the peripheral venous blood of the patients in the experimental group at 7 d after operation compared with that in the first day before operation( P>0.05),the total concentration of cfDNA in the peripheral venous blood of the patients in the experimental group was significantly lower than that in the first day of operation and 7 d after operation(P<0.05) at the 20 th d after operation,The concentration of long fragment DNA in peripheral venous blood of the experimental group was higher than that of the control group 1 d before operation,the difference was statistically significant( P<0.05).There was no significant difference in the concentration of long-segment DNA in peripheral blood of the experimental group on the 7 th d after operation( P>0.05). The long-term DNA concentration in the peripheral venous blood of the experimental group was 20 d after operation. Compared with 1 d before surgery and 7 d after operation, the difference was statistically significant(P<0.05). Conclusion The total concentration of cfDNA and long-segment DNA concentration in peripheral venous blood can indirectly reflect the tumor burden of non-small cell lung cancer patients, and it is expected to be a reference index for auxiliary diagnosis, efficacy evaluation and prognosis of non-small cell lung cancer.
Objective To investigate the clinical value of quantitative detection of total cfDNA concentration and long DNA concentration in peripheral blood of patients with operable non-small cell lung cancer. Methods From January to December 2017, 60 patients with operable non-small cell lung cancer in the Department of Thoracic Surgery, Chengde Central Hospital were selected as experimental group. Peripheral venous blood samples were collected 1 d before surgery, 7 d after surgery and 20 d after surgery. In the same period, 60 healthy people in the physical examination center of Chengde Central Hospital were selected as the control group. Peripheral venous blood samples were collected, and the total concentration of cfDNA and long DNA concentration in the blood of the two groups were quantitatively analyzed for statistical analysis. Results The total concentration of cfDNA in peripheral vein blood in the experimental group was significantly higher than that in the control group one day before operation,the difference was statistically significant(P<0.05),There was no significant change in the total concentration of cfDNA in the peripheral venous blood of the patients in the experimental group at 7 d after operation compared with that in the first day before operation( P>0.05),the total concentration of cfDNA in the peripheral venous blood of the patients in the experimental group was significantly lower than that in the first day of operation and 7 d after operation(P<0.05) at the 20 th d after operation,The concentration of long fragment DNA in peripheral venous blood of the experimental group was higher than that of the control group 1 d before operation,the difference was statistically significant( P<0.05).There was no significant difference in the concentration of long-segment DNA in peripheral blood of the experimental group on the 7 th d after operation( P>0.05). The long-term DNA concentration in the peripheral venous blood of the experimental group was 20 d after operation. Compared with 1 d before surgery and 7 d after operation, the difference was statistically significant(P<0.05). Conclusion The total concentration of cfDNA and long-segment DNA concentration in peripheral venous blood can indirectly reflect the tumor burden of non-small cell lung cancer patients, and it is expected to be a reference index for auxiliary diagnosis, efficacy evaluation and prognosis of non-small cell lung cancer.
引文
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[12]李艳,程小宪,柳玉花.肿瘤标记物检验在肺癌诊断中的临床价值评价[J].中国医药指南,2014,12(27):127.
[13]丁兰,赵超,安静,等.血浆游离DNA在临床应用中的新进展[J].现代生物医学进展,2016(18):3593-3596.
[14]丁春明,杨政权,栾菊,等.循环游离DNA检测及其临床应用进展[J].临床检验杂志,2017,35(8):564-569.
[15]郑照正,闵丽姗,钱福初,等.定量分析结直肠癌患者血浆循环游离DNA的临床价值[J].中华实验外科杂志,2018,35(3):529-532.
[16]Diehl F,Schmidt K,Choti M A,et al.Cirulating mutant DNAto assess tumor dynamics[J].Nat Med,2008,14(9):985-900.
[17]郑照,闵丽姗,钱福初,等.定量分析结直肠癌患者血浆循环游离DNA的临床价值[J].中华实验外科杂志,2018,35(3):529-532.
[18]陈亚伟,兰玲,张恒辉,等.结直肠癌患者血浆游离DNA含量与临床特征的相关性[J].胃肠病学和肝病学杂志,2017,26(6):709-712.
[19]李翔翔,陈城,王琳,等.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[J].肿瘤防治研究,2017,44(2):118-123.
[20]杨益梅,邵雪峰,张玉泉,等.血清游离DNA定量检测对宫颈癌临床诊断的价值[J].中华检验医学杂志,2013(11):992-996.
[21]万妮娅.血清cfDNA定量检测对宫颈癌早期辅助诊断及预后判断中的价值[J].中南医学科学杂志,2018(4):365-367.
[2]Chen W,Zheng R,PD B,et al.Cancer statistics in China 2015[J].CA cancer J Clin,2016,66(2):115-132.
[3]Boysen AK,Wettergren Y,Sorensen BS,et al.Cell-free DNAlevels and correlation to stage and outcome following treatmentof locally advanced rectal cancer[J].Tumour Biol,2017,39(11):3-4
[4]Zhang R,Shao F,Wu X,et al.Value of quantitative analysis ofcirculating cell free DNA as a screening tool for lung cancer:Ameta-analysis[J].Lung Cancer,2016,2(21):24-26.
[5]袁静,刘丽荣.血循环DNA的研究进展[J].贵州医药,2015(11):1045-1047.
[6]Almodovar K,Iams WT,Meador CB,et al.Longitudinal Cell-Free DNA Analysis in Patients with Small Cell Lung CancerReveals Dynamic Insights into Treatment Efficacy and DiseaseRelapse[J].Thorac Oncol,2018,13(1):112-123.
[7]Wei S,Grace ZQ,Zhonglin L,et al.Analysis of circulating tumor DNA of archived plasma samples[J].Joural Of Clinical On-cology,2016,34(15).
[8]詹先进,郑大伟.CT增强扫描技术在周围型肺癌淋巴结转移的诊断研究[J].中国CT和MRI杂志,2017(10):46-48.
[9]赵彦程,张新.支气管镜技术发展与肺癌早期诊断[J].上海医药,2018,39(7):6-9.
[10]王平.肺癌应用血清肿瘤标记物联合检测诊断的价值分析[J].当代医学,2017,23(20):139-141.
[11]程群英,邹春标.联合检测血清肿瘤标记物在恶性肿瘤诊断中的价值[J].现代预防医学,2015(22):4221-4224.
[12]李艳,程小宪,柳玉花.肿瘤标记物检验在肺癌诊断中的临床价值评价[J].中国医药指南,2014,12(27):127.
[13]丁兰,赵超,安静,等.血浆游离DNA在临床应用中的新进展[J].现代生物医学进展,2016(18):3593-3596.
[14]丁春明,杨政权,栾菊,等.循环游离DNA检测及其临床应用进展[J].临床检验杂志,2017,35(8):564-569.
[15]郑照正,闵丽姗,钱福初,等.定量分析结直肠癌患者血浆循环游离DNA的临床价值[J].中华实验外科杂志,2018,35(3):529-532.
[16]Diehl F,Schmidt K,Choti M A,et al.Cirulating mutant DNAto assess tumor dynamics[J].Nat Med,2008,14(9):985-900.
[17]郑照,闵丽姗,钱福初,等.定量分析结直肠癌患者血浆循环游离DNA的临床价值[J].中华实验外科杂志,2018,35(3):529-532.
[18]陈亚伟,兰玲,张恒辉,等.结直肠癌患者血浆游离DNA含量与临床特征的相关性[J].胃肠病学和肝病学杂志,2017,26(6):709-712.
[19]李翔翔,陈城,王琳,等.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[J].肿瘤防治研究,2017,44(2):118-123.
[20]杨益梅,邵雪峰,张玉泉,等.血清游离DNA定量检测对宫颈癌临床诊断的价值[J].中华检验医学杂志,2013(11):992-996.
[21]万妮娅.血清cfDNA定量检测对宫颈癌早期辅助诊断及预后判断中的价值[J].中南医学科学杂志,2018(4):365-367.
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