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循环肿瘤DNA中TP53突变与肝内胆管癌术后辅助化疗预后的关系
李博,贾蓬勃,李栋,李小庆 |
| The relationship between TP53 mutation in circulating tumor DNA and prognosis of intrahepatic cholangiocarcinoma after postoperative adjuvant chemotherapy |
| 投稿时间：2024-09-25 修订日期：2024-11-29 |
| DOI： |
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| 中文关键词: 循环肿瘤DNA TP53突变 肝内胆管癌 术后辅助化疗 复发 预后 |
| 英文关键词:Circulating tumor DNA TP53 mutations Intrahepatic cholangiocarcinoma Postoperative adjuvant chemotherapy Recurrence Prognosis |
| 基金项目:陕西省重点研发计划项目(2019SF-189) |
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| 摘要点击次数: 241 |
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| 中文摘要: |
| 目的 循环肿瘤DNA（ctDNA）中TP53突变与肝内胆管癌（ICC）术后辅助化疗预后的关系。方法 选取2021年1月至2022年1月在我院经病理确诊的行根治性切除术126例ICC患者，所有患者均进行术后辅助化疗。通过微滴式数字聚合酶链反应分析患者化疗前的TP53突变等位基因分数（TP53 MAF）。记录患者的无复发生存（RFS）和总生存（OS）时间。结果 复发组为78例（61.90%），无复发组为48例。复发组ICC患者的TP53 MAF显著高于无复发组患者（0.12[0.03，0.31]% vs. 0.02[0.00，0.08]%，Z=-5.796，P＜0.001）。TP53 MAF＞0.10 %患者的疾病复发风险是TP53 MAF≤0.10 %患者的3倍。TP53 MAF＞0.10 %的ICC患者复发率和死亡率更高（P＜0.001）。Kaplan-Meier曲线分析显示，TP53 MAF＞0.10 %ICC患者RFS（7.50个月[范围：2.00～27.00个月] vs. 12.00个月[范围：2.00～26.00个月]，χ2=25.429，P＜0.001）、OS（11.00个月[范围：3.50～30.00个月] vs. 14.00个月[范围：3.50～30.00个月]，χ2=9.637，P=0.002）也短于TP53 MAF≤0.10 %患者。结论 ICC患者接受根治性手术联合术后辅助化疗治疗后，拥有较高化疗前TP53突变ctDNA水平（TP53 MAF＞0.10 %）的患者复发率更高，预后更差。 |
| 英文摘要: |
| Objective: To investigate the relationship between TP53 mutation in circulating tumor DNA (ctDNA) and prognosis of intrahepatic cholangiocarcinoma (ICC) after postoperative adjuvant chemotherapy. Methods: 126 patients with ICC who underwent radical resection in our hospital from January 2021 to January 2022 were selected, and all patients received postoperative adjuvant chemotherapy. Droplet digital polymerase chain reaction was used to analyze the TP53 mutated allele fraction (TP53 MAF) of patients before chemotherapy. The recurrence-free survival (RFS) and overall survival (OS) of the patients were recorded. Results: There were 39 cases (61.90%) in the recurrence group and 24 cases in the non-recurrence group. The TP53 MAF in recurrent ICC patients was significantly higher than that in non-recurrent ICC patients (0.12[0.03, 0.31]% vs. 0.02[0.00, 0.08]%, Z=-5.796, P＜0.001). Patients with a TP53 MAF＞0.10 % had a 3-fold higher risk of disease recurrence than those with a TP53 MAF≤0.10 %. ICC patients with TP53 MAF＞0.10 % had higher recurrence and mortality rates (P＜0.001). Kaplan-Meier curve analysis showed that patients with TP53 MAF＞0.10 %ICC had RFS (7.50 months [range: 2.00～27.00 months] vs. 12.00 months [range: 2.00～26.00 months], χ2=25.429, P＜0.001) and OS (11.00 months [range: 3.50～30.00 months] vs. 14.00 months [range: 3.50～30.00 months], χ2= 9.637, P = 0.002) and shorter than TP53 MAF acuities were 0.10% of patients. Conclusions: Patients with higher ctDNA level of TP53 mutation before chemotherapy (TP53 MAF＞0.10 %) have a higher recurrence rate and worse prognosis after radical surgery combined with postoperative adjuvant chemotherapy. |
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