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Spatial analysis by current multiplexed imaging technologies for the molecular characterisation of cancer tissues 利用当前的多重成像技术进行空间分析,以确定癌症组织的分子特征。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-22 DOI: 10.1038/s41416-024-02882-6
Takashi Semba, Takatsugu Ishimoto
Tumours are composed of tumour cells and the surrounding tumour microenvironment (TME), and the molecular characterisation of the various elements of the TME and their interactions is essential for elucidating the mechanisms of tumour progression and developing better therapeutic strategies. Multiplex imaging is a technique that can quantify the expression of multiple protein markers on the same tissue section while maintaining spatial positioning, and this method has been rapidly developed in cancer research in recent years. Many multiplex imaging technologies and spatial analysis methods are emerging, and the elucidation of their principles and features is essential. In this review, we provide an overview of the latest multiplex imaging techniques by type of imaging and staining method and an introduction to image analysis methods, primarily focusing on spatial cellular properties, providing deeper insight into tumour organisation and spatial molecular biology in the TME.
肿瘤由肿瘤细胞和周围的肿瘤微环境(TME)组成,TME 各要素的分子特征及其相互作用对于阐明肿瘤进展机制和开发更好的治疗策略至关重要。多重成像是一种能在保持空间定位的情况下量化同一组织切片上多种蛋白质标记物表达的技术,这种方法近年来在癌症研究领域得到了迅速发展。许多多重成像技术和空间分析方法不断涌现,阐明其原理和特点至关重要。在这篇综述中,我们按成像和染色方法的类型概述了最新的多重成像技术,并介绍了主要侧重于细胞空间特性的图像分析方法,从而为深入了解肿瘤组织和 TME 中的空间分子生物学提供了依据。
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引用次数: 0
Correction: Comorbidity in patients with cancer treated at The Christie 更正:在克里斯蒂医院接受治疗的癌症患者的合并症。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-21 DOI: 10.1038/s41416-024-02884-4
Azadeh Abravan, Corinne Faivre-Finn, Fabio Gomes, Marcel van Herk, Gareth Price
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引用次数: 0
Non-B DNA-informed mutation burden as a marker of treatment response and outcome in cancer 作为癌症治疗反应和预后标志的非 B 基因突变负荷。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-19 DOI: 10.1038/s41416-024-02873-7
Qi Xu, Jeanne Kowalski
Genomic instability is crucial in tumorigenesis, with Tumour Mutation Burden (TMB) being a biomarker to indicate therapeutic effectiveness, particularly in immunotherapy. However, TMB is not always a reliable predictor and displays heterogeneity. Non-B DNA, susceptible to mutations, play a significant role in cancer development, indicating their potential merit when combined with mutation for enhanced markers in cancer. We assessed mutations and non-B DNA interplay as biomarkers. Our methodology quantifies tumour mutations and their co-localization with non-B DNA, using survival and drug sensitivity assessments for clinical relevance. We introduce two novel markers, ‘nbTMB’ (non-B-informed tumour mutation burden) and ‘mlTNB’ (mutation-localised tumour non-B burden). In case studies: (1) nbTMB informs on survival heterogeneity among TMB-high patients undergoing immunotherapy whereas TMB is unable to further differentiate; (2) nbTMB informs on altered cisplatin sensitivity among ovarian cancer cell lines whereas TMB is unable to differentiate; and (3) mlTNB informs on survival heterogeneity among early-stage pancreatic cancer progressors in whom other markers of genomic instability fail to differentiate. These novel markers offer a nuanced approach to enhance our understanding of treatment responses and outcomes in cancer, underscoring the need for a comprehensive exploration of the interplay between non-B and B-DNA features.
背景:基因组不稳定性在肿瘤发生过程中至关重要,而肿瘤突变负荷(TMB)是显示治疗效果的生物标志物,尤其是在免疫疗法中。然而,TMB 并不总是可靠的预测指标,而且显示出异质性。非 B 型脱氧核糖核酸容易发生突变,在癌症的发展过程中起着重要作用,这表明它们与突变结合在一起可增强癌症标记物的潜在价值:我们评估了突变和非 B 型 DNA 作为生物标志物的相互作用。我们的方法量化了肿瘤突变及其与非 B DNA 的共定位,并利用生存和药物敏感性评估临床相关性:结果:我们引入了两种新型标记物:"nbTMB"(非 B-信息肿瘤突变负荷)和 "mlTNB"(突变定位肿瘤非 B 负荷)。在案例研究中:(1) nbTMB 可以揭示接受免疫疗法的 TMB 高患者的生存异质性,而 TMB 无法进一步区分;(2) nbTMB 可以揭示卵巢癌细胞系对顺铂敏感性的改变,而 TMB 无法区分;(3) mlTNB 可以揭示早期胰腺癌进展者的生存异质性,而其他基因组不稳定性标记物无法区分这些进展者:这些新型标记物提供了一种细致入微的方法,可加深我们对癌症治疗反应和结果的理解,突出了全面探索非 BNA 和 B-DNA 特征之间相互作用的必要性。
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引用次数: 0
Improved ex vivo fluorescence imaging of human head and neck cancer using the peptide tracer TPP-IRDye800 targeting membrane-bound Hsp70 on tumor cells 利用多肽示踪剂 TPP-IRDye800 靶向肿瘤细胞膜结合 Hsp70,改进人类头颈癌的体内外荧光成像。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-15 DOI: 10.1038/s41416-024-02872-8
Katharina L. K. Holzmann, Johanna L. Wolf, Stefan Stangl, Philipp Lennartz, Atsuko Kasajima, Carolin Mogler, Bernhard Haller, Eva-Vanessa Ebert, Daniel Jira, Maren L. A. Lauterbach, Franziska von Meyer, Leonhard Stark, Leonie Mauch, Benedikt Schmidl, Barbara Wollenberg, Gabriele Multhoff, Markus Wirth
The primary goal of surgery in HNSCC is the complete resection of tumor cells with maximum preservation of normal tissue. The membrane Hsp70-targeting fluorescence labelled peptide TPP-IRDye800 represents a promising tool for real-time intraoperative tumor visualization, enabling the detection of true tumor margins, critical isles of high-grade dysplasia and LN metastases. Membrane Hsp70 (mHsp70) expression on HNSCC cell lines and primary HNSCC was determined by flow cytometry and fluorescence microscopy using FITC-conjugated mAb cmHsp70.1 and TPP. TPP-IRDye800 was sprayed on freshly resected tumor material of immunohistochemically confirmed HNSCC and LN metastases for tumor imaging. TBRs were compared using TPP-IRDye800 and Cetuximab-IRDye680, recognizing EGFR. mHsp70 expressing HNSCC cells specifically bind and internalize TPP in vitro. The TBR (2.56 ± 0.39) and AUC [0.98 CI, 0.95–1.00 vs. 0.91 CI, 0.85–0.97] of TPP-IRDye800 on primary HNSCC was significantly higher than Cetuximab-IRDye680 (1.61 ± 0.39) (p = 0.0068) and TPP-IRDye800 provided a superior tumor delineation. Fluorescence imaging showed higher AUC values than a visual inspection by surgeons [0.97 CI, 0.94–1.00 vs. 0.92 CI, 0.88–0.97] (p = 0.048). LN metastases could be visualized using TPP-IRDye800. Real-time tissue delineation was confirmed using the clinically applied KARL-STORZ imaging system. TPP-IRDye800 is a promising fluorescence imaging probe for HNSCC.
背景:HNSCC 手术的首要目标是完全切除肿瘤细胞并最大限度地保留正常组织。膜 Hsp70 靶向荧光标记肽 TPP-IRDye800 是一种很有前景的术中肿瘤实时可视化工具,可用于检测真正的肿瘤边缘、高级别发育不良的临界区和 LN 转移:方法:使用 FITC 结合物 mAb cmHsp70.1 和 TPP,通过流式细胞术和荧光显微镜测定 HNSCC 细胞系和原发性 HNSCC 的膜 Hsp70(mHsp70)表达。将 TPP-IRDye800 喷涂在经免疫组化证实的 HNSCC 和 LN 转移瘤的新鲜切除肿瘤材料上,进行肿瘤成像。使用 TPP-IRDye800 和识别表皮生长因子受体的西妥昔单抗-IRDye680 比较 TBR。TPP-IRDye800在原发性HNSCC上的TBR(2.56 ± 0.39)和AUC[0.98 CI, 0.95-1.00 vs. 0.91 CI, 0.85-0.97]显著高于西妥昔单抗-IRDye680(1.61 ± 0.39)(p = 0.0068),TPP-IRDye800能提供更好的肿瘤分界。荧光成像的 AUC 值高于外科医生的肉眼观察 [0.97 CI, 0.94-1.00 vs. 0.92 CI, 0.88-0.97] (p = 0.048)。使用 TPP-IRDye800 可以观察到 LN 转移。临床应用的 KARL-STORZ 成像系统确认了实时组织划分:结论:TPP-IRDye800是一种很有前景的HNSCC荧光成像探针。
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引用次数: 0
Identification of a 5-gene signature panel for the prediction of prostate cancer progression 确定用于预测前列腺癌进展的 5 基因特征面板。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-14 DOI: 10.1038/s41416-024-02854-w
Michelle Shen, Fernando García-Marqués, Arvind Muruganantham, Shiqin Liu, James Robert White, Abel Bermudez, Meghan A. Rice, Kelsey Thompson, Chun-Liang Chen, Chia-Nung Hung, Zhao Zhang, Tim H. Huang, Michael A. Liss, Kenneth J. Pienta, Sharon J. Pitteri, Tanya Stoyanova
Despite nearly 100% 5-year survival for localised prostate cancer, the survival rate for metastatic prostate cancer significantly declines to 32%. Thus, it is crucial to identify molecular indicators that reflect the progression from localised disease to metastatic prostate cancer. To search for molecular indicators associated with prostate cancer metastasis, we performed proteomic analysis of rapid autopsy tissue samples from metastatic prostate cancer (N = 8) and localised prostate cancer (N = 2). Then, we utilised multiple independent, publicly available prostate cancer patient datasets to select candidates that also correlate with worse prostate cancer clinical prognosis. We identified 154 proteins with increased expressions in metastases relative to localised prostate cancer through proteomic analysis. From the subset of these candidates that correlate with prostate cancer recurrence (N = 28) and shorter disease-free survival (N = 37), we identified a 5-gene signature panel with improved performance in predicting worse clinical prognosis relative to individual candidates. Our study presents a new 5-gene signature panel that is associated with worse clinical prognosis and is elevated in prostate cancer metastasis on both protein and mRNA levels. Our 5-gene signature panel represents a potential modality for the prediction of prostate cancer progression towards the onset of metastasis.
背景:尽管局部前列腺癌的 5 年生存率接近 100%,但转移性前列腺癌的生存率却大幅下降至 32%。因此,确定反映前列腺癌从局部疾病发展到转移的分子指标至关重要:为了寻找与前列腺癌转移相关的分子指标,我们对转移性前列腺癌(8 例)和局部性前列腺癌(2 例)的快速尸检组织样本进行了蛋白质组学分析。然后,我们利用多个独立、公开的前列腺癌患者数据集,筛选出与前列腺癌临床预后恶化相关的候选蛋白:结果:通过蛋白质组分析,我们确定了 154 种在转移灶中表达量相对于局部前列腺癌有所增加的蛋白质。从这些与前列腺癌复发(28 个)和较短无病生存期(37 个)相关的候选蛋白子集中,我们发现了一个 5 基因特征面板,它在预测较差的临床预后方面比单个候选蛋白有更好的表现:我们的研究提出了一个新的5基因特征面板,该面板与较差的临床预后相关,并在前列腺癌转移的蛋白质和mRNA水平上升高。我们的 5 个基因特征面板是预测前列腺癌向转移开始发展的一种潜在模式。
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引用次数: 0
Author Correction: Long-term activation of anti-tumor immunity in pancreatic cancer by a p53-expressing telomerase-specific oncolytic adenovirus 作者更正:表达p53的端粒酶特异性溶瘤腺病毒对胰腺癌抗肿瘤免疫的长期激活作用
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-14 DOI: 10.1038/s41416-024-02850-0
Masashi Hashimoto, Shinji Kuroda, Nobuhiko Kanaya, Daisuke Kadowaki, Yusuke Yoshida, Masaki Sakamoto, Yuki Hamada, Ryoma Sugimoto, Chiaki Yagi, Tomoko Ohtani, Kento Kumon, Yoshihiko Kakiuchi, Kazuya Yasui, Satoru Kikuchi, Ryuichi Yoshida, Hiroshi Tazawa, Shunsuke Kagawa, Takahito Yagi, Yasuo Urata, Toshiyoshi Fujiwara
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引用次数: 0
Imipridones inhibit tumor growth and improve survival in an orthotopic liver metastasis mouse model of human uveal melanoma 吡虫啉类药物可抑制肿瘤生长并提高人葡萄膜黑色素瘤肝转移小鼠模型的存活率。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-11 DOI: 10.1038/s41416-024-02866-6
Chandrani Chattopadhyay, Janos Roszik, Rajat Bhattacharya, Md Alauddin, Iqbal Mahmud, Sirisha Yadugiri, Mir Mustafa Ali, Fatima S. Khan, Varun Vijay Prabhu, Philip L. Lorenzi, Bo Wei, Elizabeth Burton, Rohini R. Morey, Rossana Lazcano, Michael A. Davies, Sapna P. Patel, Elizabeth A. Grimm
Uveal melanoma (UM) is a highly aggressive disease with very few treatment options. We previously demonstrated that mUM is characterized by high oxidative phosphorylation (OXPHOS). Here we tested the anti-tumor, signaling and metabolic effects of imipridones, which are CLPP activators, which inhibit OXPHOS indirectly and have demonstrated safety in patients. We assessed CLPP expression in UM patient samples. We tested the effects of imipridones (ONC201 and ONC212) on the growth, survival, signaling and metabolism of UM cell lines in vitro, and for therapeutic efficacy in vivo in UM liver metastasis models. CLPP expression was detected in primary and mUM patient samples. ONC201 and 212 decreased OXPHOS effectors, inhibited cell growth and migration, and induced apoptosis in human UM cell lines in vitro. ONC212 inhibited OXPHOS, increased metabolic stress and apoptotic pathways, inhibited amino acid metabolism, and induced cell death-related lipids. ONC212 also decreased tumor burden and increased survival in vivo in two UM liver metastasis models. Imipridones are a promising strategy for further testing and development in mUM.
背景:葡萄膜黑色素瘤(UM)是一种侵袭性很强的疾病,治疗方法很少。我们以前曾证实,黑色素瘤以高氧化磷酸化(OXPHOS)为特征。在此,我们测试了亚胺培南的抗肿瘤、信号传导和新陈代谢作用,亚胺培南是CLPP激活剂,可间接抑制OXPHOS,并已证明对患者安全:我们评估了 UM 患者样本中 CLPP 的表达。我们测试了亚胺培南(ONC201 和 ONC212)对 UM 细胞系体外生长、存活、信号传导和代谢的影响,以及对 UM 肝转移模型体内治疗效果的影响:结果:在原发性 UM 和 mUM 患者样本中检测到了 CLPP 的表达。ONC201和ONC212可减少OXPHOS效应因子,抑制细胞生长和迁移,并诱导体外人类UM细胞株凋亡。ONC212 可抑制 OXPHOS、增加代谢压力和凋亡途径、抑制氨基酸代谢并诱导细胞死亡相关脂质。在两种 UM 肝转移模型中,ONC212 还能减少肿瘤负荷,提高体内存活率:结论:咪啶酮类药物是一种很有前景的策略,可用于对荨麻疹的进一步测试和开发。
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引用次数: 0
Quiescent cancer cells induced by high-density cultivation reveals cholesterol-mediated survival and lung metastatic traits 高密度培养诱导的静止癌细胞显示出胆固醇介导的存活和肺转移特性。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-11 DOI: 10.1038/s41416-024-02861-x
Xingyang Liu, Qinjie Min, Xinxin Cheng, Weimin Zhang, Qingnan Wu, Xu Chen, Mengzhu Lv, Siqi Liu, Huihui Zhao, Di Yang, Yidi Tai, Xiao Lei, Yan Wang, Qimin Zhan
The metastatic cascade, a multifaceted and highly aggressive process, is the primary cause of mortality. The survival of quiescent cancer cells in circulatory system during metastasis is crucial, yet our comprehension is constrained by the absence of universally accepted quiescent cancer models. We developed a quiescent cancer cell model using high-density cultivation. Based on the scRNA-seq analysis, IP-MS, metabolomics, mouse lung metastasis models, cholesterol assay, PLA and other molecular experiments, we explored the molecular mechanism. Immunofluorescence, atomic force microscope, FluidFM, and shear stress stimulation were used to analyze the cytoskeleton and membrane properties contributing to mechanical force resistance. We established a quiescent cancer cell model induced by high-density cultivation. Single-cell RNA sequencing (scRNA-seq) analysis reveals that CDC25A plays a crucial role in the transition to quiescence, with its expression significantly elevated in the quiescent state. Depletion of CDC25A leads to an increased proliferative capacity, and reduced metastasis under high-density conditions. Mechanistically, upregulated CDC25A in quiescent cells enhances cholesterol metabolism via endosome pathways, leading to cell cycle arrest. This increase in cholesterol reinforces the cytoskeleton, alters membrane properties, and improves resistance to mechanical forces in circulatory system. CDC25A significantly increased the cholesterol metabolism through endosome pathway in quiescent cancer cells, leading to the significant changes in cytoskeleton and membrane properties so as to enhance the resistance of mechanical force in circulatory system, facilitating lung metastasis.
背景:转移过程是一个多方面的、高度侵袭性的过程,是导致死亡的主要原因。转移过程中静止癌细胞在循环系统中的存活至关重要,但由于缺乏公认的静止癌细胞模型,我们的理解能力受到限制:方法:我们利用高密度培养技术开发了一种静止癌细胞模型。方法:我们利用高密度培养技术建立了一个静止癌细胞模型,并基于 scRNA-seq 分析、IP-MS、代谢组学、小鼠肺转移模型、胆固醇测定、PLA 及其他分子实验,探索其分子机制。利用免疫荧光、原子力显微镜、FluidFM和剪切应力刺激等手段分析了细胞骨架和膜特性对机械力抵抗的贡献:结果:我们建立了一个由高密度培养诱导的静止癌细胞模型。单细胞 RNA 测序(scRNA-seq)分析表明,CDC25A 在向静止过渡的过程中起着关键作用,其表达量在静止状态下显著升高。消耗 CDC25A 会导致增殖能力增强,并减少高密度条件下的转移。从机理上讲,静止细胞中上调的 CDC25A 会通过内质体途径加强胆固醇代谢,导致细胞周期停滞。胆固醇的增加强化了细胞骨架,改变了膜特性,提高了循环系统对机械力的抵抗力:结论:CDC25A通过内质体途径明显增加了静止期癌细胞的胆固醇代谢,导致细胞骨架和膜特性发生显著变化,从而增强了循环系统对机械力的抵抗力,促进了肺转移。在高密度培养中,静止期癌细胞通过内质体途径上调CDC25A的胆固醇代谢,从而增强循环系统对机械力的抵抗力,促进肺转移。
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引用次数: 0
The SRC-family serves as a therapeutic target in triple negative breast cancer with acquired resistance to chemotherapy SRC家族是对化疗产生获得性抗药性的三阴性乳腺癌的治疗靶点。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1038/s41416-024-02875-5
Eivind Valen Egeland, Kotryna Seip, Eleni Skourti, Geir Frode Øy, Solveig J. Pettersen, Abhilash D. Pandya, Maria A. Dahle, Mads H. Haugen, Alexander Kristian, Sigve Nakken, Olav Engebraaten, Gunhild M. Mælandsmo, Lina Prasmickaite
Resistance to chemotherapy, combined with heterogeneity among resistant tumors, represents a significant challenge in the clinical management of triple negative breast cancer (TNBC). By dissecting molecular pathways associated with treatment resistance, we sought to define patient sub-groups and actionable targets for next-line treatment. Bulk RNA sequencing and reverse phase protein array profiling were performed on isogenic patient-derived xenografts (PDX) representing paclitaxel-sensitive and -resistant tumors. Pathways identified as upregulated in the resistant model were further explored as targets in PDX explants. Their clinical relevance was assessed in two distinct patient cohorts (NeoAva and MET500). Increased activity in signaling pathways involving SRC-family kinases (SFKs)- and MAPK/ERK was found in treatment resistant PDX, with targeted inhibitors being significantly more potent in resistant tumors. Up-regulation of SFKs- and MAPK/ERK-pathways was also detected in a sub-group of chemoresistant patients after neoadjuvant treatment. Furthermore, High SFK expression (of either SRC, FYN and/or YES1) was detected in metastatic lesions of TNBC patients with fast progressing disease (median disease-free interval 27 vs 105 months). Upregulation of SFK-signaling is found in a subset of chemoresistant tumors and is persistent in metastatic lesions. Based on pre-clinical results, these patients may respond favorably to treatment targeting SFKs.
背景:化疗耐药以及耐药肿瘤之间的异质性是三阴性乳腺癌(TNBC)临床治疗中的重大挑战。通过剖析与耐药性相关的分子通路,我们试图确定患者亚群和下一步治疗的可行靶点:方法:对代表紫杉醇敏感和耐药肿瘤的同种异源患者异种移植物(PDX)进行了大量 RNA 测序和反相蛋白质阵列分析。在耐药模型中被确定为上调的通路在 PDX 外植体中作为靶点进行了进一步探索。在两个不同的患者队列(NeoAva 和 MET500)中评估了它们的临床相关性:结果:在治疗耐药的PDX中发现,涉及SRC-家族激酶(SFKs)和MAPK/ERK的信号通路活性增加,靶向抑制剂在耐药肿瘤中的作用明显更强。在新辅助治疗后的化疗耐药患者亚群中也发现了 SFKs 和 MAPK/ERK 通路的上调。此外,在病情进展较快的TNBC患者的转移病灶中(中位无病间隔时间为27个月与105个月)也检测到了SFK的高表达(SRC、FYN和/或YES1):结论:SFK 信号的上调存在于化疗耐药的肿瘤亚群中,并在转移病灶中持续存在。根据临床前研究结果,这些患者可能会对靶向 SFKs 的治疗产生良好反应。
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引用次数: 0
Circulating tumour DNA and risk of recurrence in patients with asymptomatic versus symptomatic colorectal cancer 无症状与有症状结直肠癌患者的循环肿瘤 DNA 与复发风险。
IF 6.4 1区 医学 Q1 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1038/s41416-024-02867-5
Nadia Øgaard, Sarah Østrup Jensen, Mai-Britt Worm Ørntoft, Christina Demuth, Mads Heilskov Rasmussen, Tenna Vesterman Henriksen, Jesper Nors, Amanda Frydendahl, Iben Lyskjær, Marijana Nesic, Christina Therkildsen, Jakob Kleif, Mikail Gögenur, Lars Nannestad Jørgensen, Jesper Vilandt, Jakob Benedict Seidelin, Kåre Anderson Gotschalck, Claudia Jaensch, Berit Andersen, Uffe Schou Løve, Ole Thorlacius-Ussing, Per Vadgaard Andersen, Thomas Kolbro, Alessio Monti, Jeppe Kildsig, Peter Bondeven, Nis Hallundbæk Schlesinger, Lene Hjerrild Iversen, Morten Rasmussen, Ismail Gögenur, Jesper Bertram Bramsen, Claus Lindbjerg Andersen
Multiple initiatives aim to develop circulating tumour DNA (ctDNA) tests for early cancer detection in asymptomatic individuals. The few studies describing ctDNA-testing in both asymptomatic and symptomatic patients report lower ctDNA detection in the asymptomatic patients. Here, we explore if asymptomatic patients differ from symptomatic patients e.g. by including a ‘low-ctDNA-shedding’ and ‘less-aggressive’ subgroup. ctDNA assessment was performed in two independent cohorts of consecutively recruited patients with asymptomatic colorectal cancer (CRC) (Cohort#1: n = 215, Cohort#2: n = 368) and symptomatic CRC (Cohort#1: n = 117, Cohort#2: n = 722). After adjusting for tumour stage and size, the odds of ctDNA detection was significantly lower in asymptomatic patients compared to symptomatic patients (Cohort#1: OR: 0.4, 95%CI: 0.2–0.8, Cohort#2: OR: 0.7, 95%CI: 0.5–0.9). Further, the recurrence risk was lower in asymptomatic patients (Cohort#1: sHR: 0.6, 95%CI: 0.3–1.2, Cohort#2: sHR: 0.6, 95%CI: 0.4–1.0). Notably, ctDNA-negative asymptomatic patients had the lowest recurrence risk compared to the symptomatic patients (Cohort#1: sHR: 0.2, 95%CI: 0.1–0.6, Cohort#2: sHR: 0.3, 95%CI: 0.2–0.6). Our study suggests that asymptomatic patients are enriched for a ‘low-ctDNA-shedding-low-recurrence-risk’ subgroup. Such insights are needed to guide ctDNA-based early-detection initiatives and should prompt discussions about de-escalation of therapy and follow-up for ctDNA-negative asymptomatic CRC patients.
背景:多项研究旨在开发循环肿瘤 DNA(ctDNA)检测方法,用于无症状人群的早期癌症检测。对无症状和有症状患者进行ctDNA检测的少数研究报告显示,无症状患者的ctDNA检测率较低。在此,我们探讨了无症状患者与有症状患者是否存在差异,例如是否包括 "低ctDNA脱落 "和 "侵袭性较低 "的亚组。方法:对连续招募的无症状结直肠癌(CRC)(Cohort#1:n = 215,Cohort#2:n = 368)和有症状结直肠癌(CRC)(Cohort#1:n = 117,Cohort#2:n = 722)患者的两个独立队列进行ctDNA评估:调整肿瘤分期和大小后,无症状患者检测到ctDNA的几率明显低于有症状患者(队列#1:OR:0.4,95%CI:0.2-0.8;队列#2:OR:0.7,95%CI:0.5-0.9)。此外,无症状患者的复发风险较低(队列#1:sHR:0.6,95%CI:0.3-1.2;队列#2:sHR:0.6,95%CI:0.4-1.0)。值得注意的是,与无症状患者相比,ctDNA阴性的无症状患者复发风险最低(队列#1:sHR:0.2,95%CI:0.1-0.6;队列#2:sHR:0.3,95%CI:0.2-0.6):我们的研究表明,无症状患者中富含 "低ctDNA脱落-低复发风险 "亚群。我们的研究表明,无症状患者中富含 "低ctDNA脱落、低复发风险 "亚群,需要这样的见解来指导基于ctDNA的早期检测措施,并应促使对ctDNA阴性的无症状CRC患者进行降级治疗和随访的讨论。
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引用次数: 0
期刊
British Journal of Cancer
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