结直肠癌患者血浆游离DNA含量与临床特征的相关性
发布时间：2018-11-18 20:18
【摘要】：背景及目的结直肠癌是发病率和死亡率都极高的恶性肿瘤之一,早期无明显症状,多数患者诊断时已为中晚期,约20%的患者在初诊时就已经发生了远处转移,5年生存率仅为11.7%。提高结直肠癌的早期诊断率对于及时发现、治疗及改善患者预后非常重要,然而结直肠癌的早期诊断仍然有许多困难。血清肿瘤标志物检测是常用的结直肠癌早期筛查方法之一,然而其敏感度及特异度却不尽如人意。近年来,外周血cfDNA作为一种新的肿瘤标志物在结直肠癌的早期诊断方面起到重要作用,因其采集简便、快速、无创,可以对肿瘤患者进行实时、动态监测,在肿瘤的诊断、预后中显现出越来越重要的前景。本研究纳入结肠息肉、结肠癌、直肠癌患者,分析结肠癌及其早期病变不同分期之间血浆cfDNA水平的差异及结肠息肉、结直肠癌病变特性与血浆cfDNA水平的关系,以期为血浆cfDNA在结直肠癌的早期筛查、伴随诊断的应用中提供依据。实验方法纳入结肠息肉患者27例,结肠癌患者21例,直肠癌患者24例,收集患者临床资料,留取患者血样本,分离、提取血浆游离DNA,定量血浆游离cfDNA浓度,分析结肠癌及其早期病变不同分期之间血浆cfDNA水平的差异及结肠息肉、结直肠癌病变特性与血浆cfDNA水平的关系。应用SPSS 22.0及GraphPad Prism 5.0软件进行统计分析,统计学检验水准为α=0.05。结果1.结肠癌患者的血浆cfDNA浓度显著高于结肠息肉组患者(P0.05)。炎性/增生性息肉、非进展期腺瘤、进展期腺瘤患者血浆cfDNA浓度组间无显著差异(P0.05)。结肠癌I-II期、III期患者血浆cfDNA浓度组间无显著差异(P0.05)。2.结肠息肉患者年龄、性别、病理类型、数量、大小与血浆cfDNA水平组间比较无显著差异。3.结肠癌患者血浆cfDNA浓度显著高于直肠癌组患者(P0.05),右半结肠癌患者cfDNA浓度与左半结肠癌组患者无显著差异(P0.05)。结直肠癌患者年龄、性别、肿瘤分期、大体类型与血浆cfDNA水平组间比较无显著差异。4.血浆cfDNA水平与肿瘤TNM综合分期无相关性,与肿瘤体积大小的对数呈正相关(r=0.474,P0.01)结论血浆游离DNA水平在早期结肠良性病变到晚期结肠癌的不同时期中呈上升趋势,可有助于诊断结肠癌,并可间接反映结直肠癌患者体内的肿瘤负荷。
[Abstract]:Background and objective Colorectal cancer is one of the malignant tumors with high morbidity and mortality. There are no obvious symptoms in the early stage. Most of the patients were diagnosed with advanced stage, and about 20% of the patients had distant metastasis at the first visit. The 5-year survival rate was only 11. 7%. It is very important to improve the early diagnosis rate of colorectal cancer for timely detection, treatment and improvement of prognosis. However, there are still many difficulties in early diagnosis of colorectal cancer. Detection of serum tumor markers is one of the commonly used early screening methods for colorectal cancer, but its sensitivity and specificity are not satisfactory. In recent years, peripheral blood cfDNA, as a new tumor marker, plays an important role in the early diagnosis of colorectal cancer. More and more important prospects have emerged in the prognosis. This study included patients with colon polyps, colon cancer and rectal cancer. The difference of plasma cfDNA levels and the relationship between the pathological characteristics of colorectal cancer and plasma cfDNA levels were analyzed in different stages of colon cancer and its early lesions. To provide evidence for early screening and diagnosis of colorectal cancer with plasma cfDNA. Methods 27 patients with colonic polyps, 21 patients with colon cancer and 24 patients with rectal cancer were included in the study. The clinical data were collected, blood samples were collected, and plasma free DNA, was extracted to quantify plasma free cfDNA concentration. To analyze the difference of plasma cfDNA level between colon cancer and its early stage, and the relationship between the pathological characteristics of colorectal cancer and plasma cfDNA level. SPSS 22.0 and GraphPad Prism 5.0 software were used for statistical analysis. The statistical test level was 伪 = 0.05. Result 1. The plasma cfDNA concentration in colon cancer patients was significantly higher than that in colon polyps group (P 0.05). There was no significant difference in plasma cfDNA concentration among patients with inflammatory / proliferative polyps, non-advanced adenomas and advanced adenomas (P0.05). There was no significant difference in plasma cfDNA concentration between colon cancer patients in I-II stage and III stage (P0.05). There was no significant difference in age, sex, pathological type, quantity, size and plasma cfDNA level between patients with colonic polyps. The plasma cfDNA concentration in colon cancer patients was significantly higher than that in rectal cancer group (P0.05), while the cfDNA concentration in right colon cancer patients was not significantly different from that in left colon cancer patients (P0.05). There was no significant difference in age, sex, tumor stage, gross type and plasma cfDNA level between patients with colorectal cancer. 4. 4. There was no correlation between plasma cfDNA level and comprehensive stage of tumor TNM, but a positive correlation between plasma cfDNA level and logarithm of tumor volume (r = 0.474 / P0.01). Conclusion the level of plasma free DNA increased in different stages from early benign colon disease to advanced colon cancer. It can help to diagnose colon cancer and indirectly reflect tumor load in patients with colorectal cancer.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
本文编号：2341098
[Abstract]:Background and objective Colorectal cancer is one of the malignant tumors with high morbidity and mortality. There are no obvious symptoms in the early stage. Most of the patients were diagnosed with advanced stage, and about 20% of the patients had distant metastasis at the first visit. The 5-year survival rate was only 11. 7%. It is very important to improve the early diagnosis rate of colorectal cancer for timely detection, treatment and improvement of prognosis. However, there are still many difficulties in early diagnosis of colorectal cancer. Detection of serum tumor markers is one of the commonly used early screening methods for colorectal cancer, but its sensitivity and specificity are not satisfactory. In recent years, peripheral blood cfDNA, as a new tumor marker, plays an important role in the early diagnosis of colorectal cancer. More and more important prospects have emerged in the prognosis. This study included patients with colon polyps, colon cancer and rectal cancer. The difference of plasma cfDNA levels and the relationship between the pathological characteristics of colorectal cancer and plasma cfDNA levels were analyzed in different stages of colon cancer and its early lesions. To provide evidence for early screening and diagnosis of colorectal cancer with plasma cfDNA. Methods 27 patients with colonic polyps, 21 patients with colon cancer and 24 patients with rectal cancer were included in the study. The clinical data were collected, blood samples were collected, and plasma free DNA, was extracted to quantify plasma free cfDNA concentration. To analyze the difference of plasma cfDNA level between colon cancer and its early stage, and the relationship between the pathological characteristics of colorectal cancer and plasma cfDNA level. SPSS 22.0 and GraphPad Prism 5.0 software were used for statistical analysis. The statistical test level was 伪 = 0.05. Result 1. The plasma cfDNA concentration in colon cancer patients was significantly higher than that in colon polyps group (P 0.05). There was no significant difference in plasma cfDNA concentration among patients with inflammatory / proliferative polyps, non-advanced adenomas and advanced adenomas (P0.05). There was no significant difference in plasma cfDNA concentration between colon cancer patients in I-II stage and III stage (P0.05). There was no significant difference in age, sex, pathological type, quantity, size and plasma cfDNA level between patients with colonic polyps. The plasma cfDNA concentration in colon cancer patients was significantly higher than that in rectal cancer group (P0.05), while the cfDNA concentration in right colon cancer patients was not significantly different from that in left colon cancer patients (P0.05). There was no significant difference in age, sex, tumor stage, gross type and plasma cfDNA level between patients with colorectal cancer. 4. 4. There was no correlation between plasma cfDNA level and comprehensive stage of tumor TNM, but a positive correlation between plasma cfDNA level and logarithm of tumor volume (r = 0.474 / P0.01). Conclusion the level of plasma free DNA increased in different stages from early benign colon disease to advanced colon cancer. It can help to diagnose colon cancer and indirectly reflect tumor load in patients with colorectal cancer.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34
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相关期刊论文 前3条
1 姜艳芳;魏志;孙自勤;;中国青年大肠癌发病趋势分析[J];胃肠病学和肝病学杂志;2016年09期
2 王宁;孙婷婷;郑荣寿;张思维;陈万青;;中国2009年结直肠癌发病和死亡资料分析[J];中国肿瘤;2013年07期
3 Ken Chen;Hong Zhang;Li-Na Zhang;Shao-Qing Ju;Jing Qi;Dong-Feng Huang;Feng Li;Qun Wei;Jing Zhang;;Value of circulating cell-free DNA in diagnosis of hepatocelluar carcinoma[J];World Journal of Gastroenterology;2013年20期
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