医学研究与教育 ›› 2020, Vol. 37 ›› Issue (6): 23-28.DOI: 10.3969/j.issn.1674-490X.2020.06.004

• 临床医学 • 上一篇    下一篇

外周血ctDNA基因突变对早中期非小细胞肺癌患者的诊断效能分析

李鹤飞1,王海波1,李伟1,史鸿云2,贾友超3   

  1. 1.河北大学附属医院胸外科, 河北 保定 071000;
    2.河北大学附属医院放疗科, 河北 保定 071000;
    3.河北大学附属医院肿瘤科, 河北 保定 071000
  • 收稿日期:2019-12-05 出版日期:2020-12-25 发布日期:2020-12-25
  • 作者简介:李鹤飞(1979—),男,河北唐县人,副主任医师,博士,主要从事胸外科肿瘤科研与治疗。 E-mail: 1776160714@qq.com
  • 基金资助:
    河北省医学科学研究课题计划项目(20190941)

  • Received:2019-12-05 Online:2020-12-25 Published:2020-12-25

摘要: 目的 分析外周血循环肿瘤DNA(circulating tumor DNA, ctDNA)基因突变对非小细胞肺癌患者的诊断效能。方法 纳入2016年12月至2017年12月在河北大学附属医院初诊初治且行单孔胸腔镜手术治疗的50例非小细胞肺癌(non-small cell lung cancer, NSCLC)患者为研究对象。收集所有研究对象外周血后分离血浆,并提取ctDNA。 Illumina HiSeq 3000平台进行目标区域的高通量测序,并以基因突变频率作为ctDNA的检测分析指标。结果 50例患者ctDNA检测非小细胞肺癌的敏感性明显高于血清中癌胚抗原检测的敏感性(P<0.05);ctDNA基因突变频率在不同年龄、性别、病理类型、吸烟史等患者间差异无统计学意义(P>0.05),而在不同肿瘤大小及临床分期患者中差异有统计学意义(P<0.05)。结论 外周血ctDNA基因突变可敏感诊断早中期NSCLC,且与早中期NSCLC肿瘤大小及临床分期有相关性。

关键词: 循环肿瘤DNA, 基因突变, 非小细胞肺癌, 诊断, 基因突变频率

Abstract: Objective To analyze the diagnostic efficacy of ctDNA gene mutations in peripheral blood in patients with NSCLC. Methods 50 patients with non-small cell lung cancer were newly diagnosed and treated in Affiliated Hospital of Hebei University with single-hole thoracoscopic surgery. After collecting the peripheral blood of all the subjects, plasma was separated and ctDNA was extracted. The Illumina HiSeq 3000 platform was applied to examine high-throughput sequencing of the target area, and the frequency of gene mutation served as detection and analysis index for ctDNA. Results The sensitivity and specificity of ctDNA detection of non-small cell lung cancer in 50 patients with non-small cell lung cancer were significantly higher than those of CEA detection(P<0.05). The frequency of ctDNA mutations in different ages, genders, and pathological types, smoking history, etc.had no significant difference between patients(P>0.05), but there were significant differences among patients with different tumor sizes and clinical stages(P<0.05). Conclusion The mutation of ctDNA gene in peripheral blood can be used for sensitive and specific diagnosis of early and mid-stage non-small cell lung cancer, and it is related to the tumor size and clinical stage of NSCLC in the early and middle stages.

Key words: circulating tumor DNA, gene mutation, non-small cell lung cancer, diagnosis, gene mutation frequency

中图分类号: