| 李 博,贾蓬勃,李 栋,等.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[J].肿瘤学杂志,2025,31(10):878-883. |
| 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 |
| Relationship Between TP53 Mutation in Circulating Tumor DNA and Prognosis of Patients with Intrahepatic Cholangiocarcinoma After Postoperative Adjuvant Chemotherapy |
| 投稿时间：2024-09-25 |
| DOI：10.11735/j.issn.1671-170X.2025.10.B008 |
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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 mutation 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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| 中文摘要: |
| 摘 要： ［目的］探讨循环肿瘤DNA（circulating tumor DNA ，ctDNA）中TP53突变与肝内胆管癌（intrahepatic cholangiocarcinoma，ICC）术后辅助化疗预后的关系。［方法］ 选取2021年1月至2022年1月在咸阳市第一人民医院经病理确诊的行根治性切除术的ICC患者126例，患者均行术后辅助化疗。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 mutated allele fraction，TP53 MAF）。记录患者的无复发生存（recurrence-free survival，RFS）和总生存（overall survival，OS）时间。［结果］ 126例患者中复发78例（61.90%）。复发组ICC患者的TP53 MAF显著性高于无复发组患者［0.12%（0.03%，0.31%） vs 0.02%（0.00%，0.08%），Z=-5.796，P＜0.001］。多因素分析显示，TP53 MAF＞0.10%是患者复发的独立危险因素（HR=2.795，95CI%：1.341~5.827，P=0.006）。TP53 MAF＞0.10%的ICC患者复发率和死亡率均更高（P＜0.001）。TP53 MAF＞0.10% ICC患者中位RFS时间、中位OS时间均显著性短于TP53 MAF≤0.10%患者（7.50个月 vs 12.00个月，χ2=25.429，P＜0.001；11.00个月vs 14.00个月，χ2=9.637，P=0.002）。［结论］ ICC患者接受根治性手术联合术后辅助化疗后，化疗前TP53突变ctDNA水平较高的患者复发率更高，预后更差。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the relationship between TP53 mutation in circulating tumor DNA (ctDNA) and prognosis of patients with intrahepatic cholangiocarcinoma (ICC) after postoperative adjuvant chemotherapy. ［Methods］One hundred and twenty-six patients with ICC who underwent radical resection and received postoperative adjuvant chemotherapy in Xianyang First People’s Hospital from January 2021 to January 2022 were enrolled in the study. The TP53 mutated allele fraction(TP53 MAF) was detected by droplet digital polymerase chain reaction (ddPCR) in patients before chemotherapy. The recurrence-free survival (RFS) and overall survival (OS) of the patients were recorded. ［Results］ Among the 126 patients， 78 cases (61.90%) experienced recurrence. The TP53 MAF in recurrence group was significantly higher than that in non-recurrence group ［0.12% (0.03%， 0.31%) vs 0.02% (0.00%， 0.08%)， Z=-5.796， P＜0.001］. Multivariate analysis showed that TP53 MAF>0.10% was an independent risk factor for patient recurrence (HR=2.795， 95%CI： 1.341~5.827， P=0.006). ICC patients with TP53 MAF＞0.10% had higher recurrence and mortality rates (P＜0.001). The median RFS and OS in patients with TP53 MAF>0.10% were significantly shorter than those in patients with TP53 MAF ≤0.10% (7.50 months vs 12.00 months， χ2=25.429， P<0.001； 11.00 months vs 14.00 months， χ2=9.637， P=0.002). ［Conclusion］ ICC patients with higher level of ctDNA TP53 mutation before chemotherapy have a higher recurrence rate and worse prognosis after radical surgery and postoperative adjuvant chemotherapy. |
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