Translational research : the journal of laboratory and clinical medicine · 2025
Effectiveness of circulating tumor cells and circulating tumor DNA in peritoneal lavage fluid for predicting metachronous peritoneal metastasis of gastric cancer.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Bai Long, Ni Bo, Shen Xiaoyao, Zhang Yeqian, Guan Yujing, Gu Jiayi, Zhang Haoyu, Aimaiti Muerzhate, Wang Shuchang, Yue Ben, Shen Yanying, Liu Zebing, Xia Xiang, Zhang Zizhen
Аннотация
BACKGROUND: Peritoneal metastasis is a leading cause of death in gastric cancer (GC) patients, highlighting the need for early diagnosis and high-risk population identification. While circulating tumor DNA(ctDNA) and circulating tumor cells (CTC) have been widely studied in blood, their role in peritoneal lavage fluid (PLF) remains unexplored.
METHODS: Patients with stage III GC were enrolled, and preoperative/postoperative PLF was collected in this study. ctDNA in PLF supernatant was analyzed via next-generation sequencing (NGS), while CTC in the pellet were detected using Epithelial Cell Adhesion Molecule (EpCAM), Folate Receptor (FR), and Cytokeratin (CK) immunofluorescence.
RESULTS: ctDNA-positive patients had higher peritoneal metastasis risk (preoperative HR: 4.82, 95% CI 1.03-22.54, p = 0.04; postoperative HR: 4.83, 95% CI 1.03-22.54, p = 0.04). CTC-positive patients also showed higher risk (preoperative HR: 6.76, 95% CI 0.92-49.74, p = 0.003; postoperative HR: 7.41, 95% CI 1.67-32.87, p = 0.02). Postoperative ctDNA had higher predictive efficacy for peritoneal metastasis compared to preoperative ctDNA, with AUC values of 0.93 and 0.86. Combined ctDNA/CTC positivity identified the highest recurrence risk (preoperative HR: 8.07, 95% CI 0.96-67.51, p = 0.0012; postoperative HR: 18.14, 95% CI 3.27-100.70, p = 0.0002).
CONCLUSIONS: The combination of postoperative ctDNA and CTC in PLF offered the highest accuracy (85%) and risk stratification in predicting peritoneal metastasis (30.30% vs. 66.67%, p = 0.0063). This method may guide the postoperative prophylactic intraperitoneal chemotherapy.
METHODS: Patients with stage III GC were enrolled, and preoperative/postoperative PLF was collected in this study. ctDNA in PLF supernatant was analyzed via next-generation sequencing (NGS), while CTC in the pellet were detected using Epithelial Cell Adhesion Molecule (EpCAM), Folate Receptor (FR), and Cytokeratin (CK) immunofluorescence.
RESULTS: ctDNA-positive patients had higher peritoneal metastasis risk (preoperative HR: 4.82, 95% CI 1.03-22.54, p = 0.04; postoperative HR: 4.83, 95% CI 1.03-22.54, p = 0.04). CTC-positive patients also showed higher risk (preoperative HR: 6.76, 95% CI 0.92-49.74, p = 0.003; postoperative HR: 7.41, 95% CI 1.67-32.87, p = 0.02). Postoperative ctDNA had higher predictive efficacy for peritoneal metastasis compared to preoperative ctDNA, with AUC values of 0.93 and 0.86. Combined ctDNA/CTC positivity identified the highest recurrence risk (preoperative HR: 8.07, 95% CI 0.96-67.51, p = 0.0012; postoperative HR: 18.14, 95% CI 3.27-100.70, p = 0.0002).
CONCLUSIONS: The combination of postoperative ctDNA and CTC in PLF offered the highest accuracy (85%) and risk stratification in predicting peritoneal metastasis (30.30% vs. 66.67%, p = 0.0063). This method may guide the postoperative prophylactic intraperitoneal chemotherapy.