Volume 29, Issue 5, 2020
DOI: 10.24205/03276716.2020.1171
Clinical significance of plasma free DNA concentration and integrity in detection of primary hepatocellular carcinoma
Abstract
cell-free DNA (cfDNA) concentration and integrity in the detection of primary liver cancer (PLC).
Methods: Select 96 PLC patients confirmed by the second hospital of Nanjing as the research group and record the basic clinical information of the patients in detail. Another 50 healthy subjects from the same physical examination were included as the control group. After the qRT-PCR method was used to determine the plasma cfDNA concentration of all subjects, the integrity was calculated. Combined with the basic clinical data of PLC patients, the relationship between cfDNA concentration and integrity and the clinical characteristics of patients was analyzed. Receiver operating characteristic (ROC) curves of cfDNA concentration, cfDNA integrity and other tumor markers (AFP, HEPPAR-1, KI-67, GPC-3, CK19 and CD31) were established to analyze the diagnostic efficacy of each indicator for PLC. Kaplan-meier univariate analysis and COX multivariate analysis were used to analyze the factors affecting the recurrence rate of PLC patients, and to compare the relapse-free survival (RFS) of PLC patients with high and low cfDNA expression after treatment.
Results: Before treatment, the plasma cfDNA concentration and integrity of PLC patients were significantly higher than that of healthy people (P<0.05). After treatment, the cfDNA concentration and integrity were significantly lower than before treatment (P<0.05), but still higher than that of healthy people (P<0.05). CfDNA concentration was significantly correlated with tumor diameter, differentiation degree, BCLC stage and AFP level in PLC patients (P<0.05), while cfDNA integrity was significantly correlated with differentiation degree, BCLC stage and AFP level in PLC patients (P<0.05). ROC curve results showed that the area under the curve (AUC) of cfDNA concentration and integrity was higher than other tumor markers, and had higher sensitivity and specificity. Kaplan-meier univariate analysis showed that tumor size, AFP, BCLC stage, cfDNA concentration and integrity were significant prognostic factors, and COX multivariate analysis further showed that BCLC stage and cfDNA concentration were independent risk factors for recurrence in PLC patients. After treatment, patients with low plasma cfDNA expression had longer RFS and lower recurrence rates.
Conclusion: CfDNA concentration and integrity have better diagnostic efficacy and prognostic evaluation ability, and can be used as a potential marker of PLC.
Keywords
cfDNA concentration; cfDNA integrity; PLC; diagnose; prognosis