Peritoneal Lavage Tumor DNA as a Novel Biomarker for Predicting Peritoneal Recurrence in Pancreatic Ductal Adenocarcinom
- PDF / 397,506 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 90 Downloads / 213 Views
ORIGINAL ARTICLE – PANCREATIC TUMORS
Peritoneal Lavage Tumor DNA as a Novel Biomarker for Predicting Peritoneal Recurrence in Pancreatic Ductal Adenocarcinoma Masaya Suenaga, MD, PhD1,2, Tsutomu Fujii, MD, PhD, FACS1,3, Suguru Yamada, MD, PhD1, Masamichi Hayashi, MD, PhD1, Keiko Shinjo, MD, PhD4, Hideki Takami, MD, PhD1, Yukiko Niwa, MD, PhD1, Fuminori Sonohara, MD, PhD1, Dai Shimizu, MD, PhD1, Mitsuro Kanda, MD, PhD1, Daisuke Kobayashi, MD, PhD1, Chie Tanaka, MD, PhD1, Goro Nakayama, MD, PhD1, Masahiko Koike, MD, PhD1, Michitaka Fujiwara, MD, PhD1, Yutaka Kondo, MD, PhD4, and Yasuhiro Kodera, MD, PhD1 1
Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan; 2Department of Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; 3 Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan; 4Division of Cancer Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
ABSTRACT Background. The clinical role of peritoneal lavage cytology (CY) in pancreatic ductal adenocarcinoma (PDAC) remains controversial, partly due to its low sensitivity. This study aimed to develop a new biomarker, defined as peritoneal lavage tumor DNA (ptDNA), using DNAs extracted from peritoneal lavage samples from patients with PDAC. Methods. Samples were collected intraoperatively from 89 PDAC patients who underwent pancreatectomy between 2012 and 2017. Droplet digital polymerase chain reaction (PCR) was used to measure ptDNA for detection of KRAS mutations. The ptDNA status and clinical characteristics were retrospectively evaluated. Results. Positive ptDNA was found in 41 patients, including all 9 patients positive for CY (CY?) and 32 patients negative for CY (CY-). The mutant allele
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-08990-w) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 24 April 2020 Accepted: 19 July 2020 T. Fujii, MD, PhD, FACS e-mail: [email protected]
frequency was significantly higher in the CY? patients than in the CY- patients. The disease-free survival (DFS) and overall survival (OS) were significantly poorer in the high-ptDNA group than in the low-ptDNA group (median DFS, 11.0 vs. 18.8 months; p = 0.007; median OS, 28.7 vs not reached; p = 0.001). The survival curves of DFS and OS in the CY? group were almost equal to those in the CY- and high-ptDNA group. In a multivariable analysis, ptDNA was an independent predictive factor for DFS (p = 0.025) and OS (p = 0.047). The estimated cumulative incidence of peritoneal recurrence was 45.5% in the highptDNA group. The ptDNA biomarker had a much higher sensitivity for peritoneal recurrence than CY, whereas CY had higher specificity. Conclusions. As a promising biomarker, ptDNA may predict poor prognosis and peritoneal recurrence in PDAC, resolving the controve
Data Loading...
