結(jié)直腸癌患者血漿游離DNA含量與臨床特征的相關(guān)性
發(fā)布時(shí)間：2018-11-18 20:18
【摘要】：背景及目的結(jié)直腸癌是發(fā)病率和死亡率都極高的惡性腫瘤之一,早期無(wú)明顯癥狀,多數(shù)患者診斷時(shí)已為中晚期,約20%的患者在初診時(shí)就已經(jīng)發(fā)生了遠(yuǎn)處轉(zhuǎn)移,5年生存率僅為11.7%。提高結(jié)直腸癌的早期診斷率對(duì)于及時(shí)發(fā)現(xiàn)、治療及改善患者預(yù)后非常重要,然而結(jié)直腸癌的早期診斷仍然有許多困難。血清腫瘤標(biāo)志物檢測(cè)是常用的結(jié)直腸癌早期篩查方法之一,然而其敏感度及特異度卻不盡如人意。近年來,外周血cfDNA作為一種新的腫瘤標(biāo)志物在結(jié)直腸癌的早期診斷方面起到重要作用,因其采集簡(jiǎn)便、快速、無(wú)創(chuàng),可以對(duì)腫瘤患者進(jìn)行實(shí)時(shí)、動(dòng)態(tài)監(jiān)測(cè),在腫瘤的診斷、預(yù)后中顯現(xiàn)出越來越重要的前景。本研究納入結(jié)腸息肉、結(jié)腸癌、直腸癌患者,分析結(jié)腸癌及其早期病變不同分期之間血漿cfDNA水平的差異及結(jié)腸息肉、結(jié)直腸癌病變特性與血漿cfDNA水平的關(guān)系,以期為血漿cfDNA在結(jié)直腸癌的早期篩查、伴隨診斷的應(yīng)用中提供依據(jù)。實(shí)驗(yàn)方法納入結(jié)腸息肉患者27例,結(jié)腸癌患者21例,直腸癌患者24例,收集患者臨床資料,留取患者血樣本,分離、提取血漿游離DNA,定量血漿游離cfDNA濃度,分析結(jié)腸癌及其早期病變不同分期之間血漿cfDNA水平的差異及結(jié)腸息肉、結(jié)直腸癌病變特性與血漿cfDNA水平的關(guān)系。應(yīng)用SPSS 22.0及GraphPad Prism 5.0軟件進(jìn)行統(tǒng)計(jì)分析,統(tǒng)計(jì)學(xué)檢驗(yàn)水準(zhǔn)為α=0.05。結(jié)果1.結(jié)腸癌患者的血漿cfDNA濃度顯著高于結(jié)腸息肉組患者(P0.05)。炎性/增生性息肉、非進(jìn)展期腺瘤、進(jìn)展期腺瘤患者血漿cfDNA濃度組間無(wú)顯著差異(P0.05)。結(jié)腸癌I-II期、III期患者血漿cfDNA濃度組間無(wú)顯著差異(P0.05)。2.結(jié)腸息肉患者年齡、性別、病理類型、數(shù)量、大小與血漿cfDNA水平組間比較無(wú)顯著差異。3.結(jié)腸癌患者血漿cfDNA濃度顯著高于直腸癌組患者(P0.05),右半結(jié)腸癌患者cfDNA濃度與左半結(jié)腸癌組患者無(wú)顯著差異(P0.05)。結(jié)直腸癌患者年齡、性別、腫瘤分期、大體類型與血漿cfDNA水平組間比較無(wú)顯著差異。4.血漿cfDNA水平與腫瘤TNM綜合分期無(wú)相關(guān)性,與腫瘤體積大小的對(duì)數(shù)呈正相關(guān)(r=0.474,P0.01)結(jié)論血漿游離DNA水平在早期結(jié)腸良性病變到晚期結(jié)腸癌的不同時(shí)期中呈上升趨勢(shì),可有助于診斷結(jié)腸癌,并可間接反映結(jié)直腸癌患者體內(nèi)的腫瘤負(fù)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 偽 = 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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.34
本文編號(hào)：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 偽 = 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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.34
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
1 姜艷芳;魏志;孫自勤;;中國(guó)青年大腸癌發(fā)病趨勢(shì)分析[J];胃腸病學(xué)和肝病學(xué)雜志;2016年09期
2 王寧;孫婷婷;鄭榮壽;張思維;陳萬(wàn)青;;中國(guó)2009年結(jié)直腸癌發(fā)病和死亡資料分析[J];中國(guó)腫瘤;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
，本文編號(hào)：2341098
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