循环肿瘤DNA联合内镜反应评估对食管鳞状细胞癌的临床意义
Clinical significance of combining circulating tumor DNA and endoscopic response evaluation for esophageal squamous cell carcinoma.
作者
作者单位
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. s.matsuda.a8@keio.jp.
- Center for Cancer Genomics, Keio University School of Medicine, Tokyo, Japan.
摘要
中文
我们先前证明了血液中循环肿瘤DNA（ctDNA）在评估食管鳞状细胞癌（ESCC）肿瘤负荷方面的实用性。我们还发现内镜反应评估可预测ESCC患者的预后。在本研究中，我们确定术后NAC ctDNA与内镜评估的结合是否能改善ESCC患者预后的预测。我们回顾了2019年至2024年间在庆应义塾大学医院接受新辅助化疗（NAC）和手术的31例ESCC患者。在NAC前后收集用于ctDNA分析的血样。基于内镜发现定义内镜应答者（ER）。根据NAC后ctDNA和ER状态将患者分为三组：（A）ctDNA阴性和ER，（B）ctDNA阴性和非ER，（C）ctDNA阳性。研究了无复发生存期（RFS）和病理淋巴结状态。从31例患者中收集了60份血样。其中，29例在NAC前ctDNA阳性，13例在NAC后转为阴性。10例观察到ER。ctDNA阴性患者的3年RFS显著高于ctDNA阳性患者（74% vs. 12%，p=0.001）。结合ctDNA和ER时，A组在随访期间无复发。A、B、C组的3年RFS分别为100%、53%和12%（p=0.004）。A组中80%的患者无淋巴结转移。NAC后ctDNA与ER的结合能更准确地预测预后。这些指标将有助于ESCC治疗的个体化。
English
We previously demonstrated the usefulness of circulating tumor DNA (ctDNA) in blood for assessing tumor burden for esophageal squamous cell carcinoma (ESCC). We also found that endoscopic response evaluation predicted the prognosis of ESCC patients. In this study, we determined whether the combination of post-NAC ctDNA with endoscopic evaluation can improve the prediction of the prognosis in ESCC patients. Thirty-one patients with ESCC treated with neoadjuvant chemotherapy (NAC) and surgery at Keio University Hospital between 2019 and 2024 were reviewed. Blood samples for ctDNA analysis were collected before and after NAC. An endoscopic responder (ER) was defined based on the endoscopic findings. Patients were classified into three groups by post-NAC ctDNA and ER status: (A) ctDNA-negative and ER, (B) ctDNA-negative and non-ER, and (C) ctDNA-positive. Recurrence-free survival (RFS) and pathological lymph node status were investigated. Sixty blood samples were collected from 31 patients. Of these patients, 29 were ctDNA-positive before NAC, and 13 became negative after NAC. ER was observed in 10 patients. Three-year RFS was significantly higher in ctDNA-negative than in ctDNA-positive (74% vs. 12%, p = 0.001). When combining ctDNA and ER, group A had no recurrences during follow-up. Three-year RFS rates for groups A, B, and C were 100, 53, and 12%, respectively (p = 0.004). 80% of group A patients showed no lymph node metastasis. The combination of post-NAC ctDNA and ER predicts the prognosis more accurately. These indicators will individualize ESCC treatment.
分类与指标
- 研究类型
- 临床研究
- 病种
- 食管癌
- JCR 分区
- Q1
- 影响因子
- 5.8
- 新锐分区
- 4区