Abstract
Simple SummaryCirculating cell-free DNA (cfDNA) in patients with ampullary cancer was measured to clarify the correlation between cfDNA and clinicopathological factors and the impact of cfDNA on survival outcomes. The level of cfDNA was significantly higher in patients with lymph node involvement, lymphovascular invasion, abnormal serum carcinoembryonic antigen level, and stage II and III cancer. The 1- and 5-year survival rates were 92.0% and 66.5%, respectively, for patients with low cfDNA levels ≤ 6687 copies/mL as compared with 84.0% and 49.9%, respectively, for patients with high cfDNA levels > 6687 copies/mL (p < 0.001). After multivariate analysis, only the cfDNA level and cancer stage were independent factors in determining the prognosis of the ampullary cancer. The cfDNA level could act as a surrogate marker of both disease extent and biological aggressiveness of ampullary cancer. Moreover, cfDNA plays a significant role in determining the prognosis of resectable ampullary cancer.Circulating cell-free DNA (cfDNA) in ampullary cancer patients was measured to clarify the correlation between cfDNA and clinicopathological factors and the impact of cfDNA on survival outcomes. Patients with ampullary cancer undergoing pancreaticoduodenectomy were included. Correlations between cfDNA and clinicopathological and prognostic factors were determined. The cfDNA levels in patients ranged from 1282 to 21,674 copies/mL, with a median of 6687 copies/mL. The cfDNA level was significantly higher in patients with lymph node involvement, lymphovascular invasion, abnormal serum carcinoembryonic antigen (CEA) level, and stage II and III cancer. Poor prognostic factors for ampullary cancer included high cfDNA > 6687 copies/mL, lymph node involvement, abnormal serum CEA > 5 ng/mL, and advanced stage II and III cancer. The 1- and 5-year survival rates were 92.0% and 66.5%, respectively, for patients with low cfDNA < 6687 copies/mL and 84.0% and 49.9%, respectively, for patients with high cfDNA > 6687 copies/mL (p < 0.001). After multivariate analysis, only the cfDNA level and stage were independent prognostic factors of ampullary cancer. Thus, the cfDNA level could act as a surrogate marker of both disease extent and biological aggressiveness of ampullary cancer. Moreover, cfDNA plays a significant role in the prognosis of resectable ampullary cancer.
Highlights
Circulating cell-free DNA in plasma has attracted great interest in cancer research due to its noninvasive manner of use in cancer diagnosis and monitoring, or the socalled “liquid biopsy” [1,2]
The cell-free DNA (cfDNA) level was measured in 100 patients with ampullary cancer undergoing pancreaticoduodenectomy
CfDNA levels were significantly higher in patients with lymph node involvement, lymphovascular invasion, abnormal serum carcinoembryonic antigen (CEA) level
Summary
Circulating cell-free DNA (cfDNA) in plasma has attracted great interest in cancer research due to its noninvasive manner of use in cancer diagnosis and monitoring, or the socalled “liquid biopsy” [1,2]. Some studies have shown that patients with malignancy are associated with higher levels of cfDNA than healthy individuals [1,3]. There is an increase in cell turnover during tumorigenesis, resulting in more necrotic and apoptotic cells, which could be released into the bloodstream and lead to an accumulation of cfDNA [4]. This theory might explain why cancer patients tend to have higher cfDNA levels than normal healthy patients [5]. Based on the concept of “liquid biopsy”, cfDNA has recently been considered as a promising prognostic biomarker in patients with various types of cancer [1,6,7,8,9,10,11,12]
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