Ann Surg Treat Res.  2014 Mar;86(3):136-142. 10.4174/astr.2014.86.3.136.

Circulating cell-free DNA as a promising biomarker in patients with gastric cancer: diagnostic validity and significant reduction of cfDNA after surgical resection

• Kim K
• Shin DG
• Park MK
• Baik SH
• Kim TH
• Kim S
• Lee S

• KMID: 2266894
• DOI: http://doi.org/10.4174/astr.2014.86.3.136

Abstract

PURPOSE
The aim of this study is to determine whether levels of circulating free DNA (cfDNA) increase according to cancer progression, whether they are restored after surgical resection, and to evaluate cfDNA in gastric cancer patients as a useful biomarker.
METHODS
A case-control study design was used. Thirty gastric cancer patients and 34 healthy subjects were enrolled from two hospitals in South Korea. The plasma cfDNA of patients with gastric cancer were obtained before surgery and 24 hours after surgery, and then analyzed by a quantitative, real-time polymerase chain reaction. Plasma samples were also obtained from the control group.
RESULTS
The mean levels of cfDNA in the healthy control group, patients with early gastric cancer, and with advanced gastric cancer were 79.78 +/- 8.12 ng/mL, 106.88 +/- 12.40 ng/mL, and 120.23 +/- 10.08 ng/mL, respectively (P < 0.01). Sensitivity was 96.67% and specificity was 94.11% when the cutoff value was 90 ng/mL. Variables representing the tumor burden such as tumor size, T stage, TNM stage, and curative resection are also associated with the levels of cfDNA. The levels of cfDNA in the 24-hour-after-surgery group decreased significantly (112.17 +/- 13.42 ng/mL vs. 77.93 +/- 5.94 ng/mL, P < 0.001) compared to the levels of cfDNA in the preoperation group.
CONCLUSION
The changes in the levels of cfDNA can act as reliable biomarkers to detect cancer early, to predict tumor burden, estimate curative resection and even prognosis.

Keyword

Circulating free DNA; Biological biomarker; Gastric neoplasms

MeSH Terms

Biomarkers
Case-Control Studies
DNA*
Humans
Plasma
Prognosis
Real-Time Polymerase Chain Reaction
Republic of Korea
Sensitivity and Specificity
Stomach Neoplasms*
Tumor Burden
DNA

Figure

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  Fig. 1 Comparison of circulating free DNA among healthy subjects (white), early gastric cancer (EGC) groups (gray), and advanced gastric cancer (AGC, black) groups.

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  Fig. 2 Receiver operating characteristic (ROC) curve of circulating free DNA between cancer patients and healthy controls. AUC, area under the curve.

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  Fig. 3 Comparison of mean circulating free DNA levels between pre- and postoperation in patients with gastric cancer.

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