Non-invasive early detection of cancer four years before conventional diagnosis using a blood test
Non-invasive early detection of cancer four years before conventional diagnosis using a blood test
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使用血液测试在常规诊断前四年进行非侵入性早期癌症检测
DOI：
10.1038/s41467-020-17316-z
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发表时间：
2020-07-21
影响因子：
16.6
通讯作者：
Jin, Li
中科院分区：
文献类型：
--
作者：
Chen, Xingdong;Gole, Jeffrey;Jin, Li
早期检测有可能降低癌症死亡率，但有效的筛查测试必须在纵向研究中的常规诊断之前数年证明无症状癌症的检测。在台州纵向研究（TZL）中，123,115 名健康受试者提供了血浆样本进行长期储存，然后监测癌症发生情况。在此，我们报告了 PanSeer（一种基于循环肿瘤 DNA 甲基化的无创血液检测）对 605 名无症状个体的 TZL 血浆样本的初步结果，其中 191 人后来在抽血四年内被诊断出患有胃癌、食道癌、结直肠癌、肺癌或肝癌。我们还检测了另外 223 名癌症患者以及 200 名原发性肿瘤和正常组织的血浆样本。我们表明 PanSeer 在 88%（95% CI：80-93%）的诊断后患者中检测出五种常见类型的癌症，特异性为 96%（95% CI：93-98%）。我们还证明 PanSeer 在后来诊断的无症状个体中检测出 95%（95% CI：89-98%）的癌症，尽管需要未来的纵向研究来证实这一结果。这些结果表明，癌症可以在当前标准护理之前四年进行非侵入性检测。
Early detection has the potential to reduce cancer mortality, but an effective screening test must demonstrate asymptomatic cancer detection years before conventional diagnosis in a longitudinal study. In the Taizhou Longitudinal Study (TZL), 123,115 healthy subjects provided plasma samples for long-term storage and were then monitored for cancer occurrence. Here we report the preliminary results of PanSeer, a noninvasive blood test based on circulating tumor DNA methylation, on TZL plasma samples from 605 asymptomatic individuals, 191 of whom were later diagnosed with stomach, esophageal, colorectal, lung or liver cancer within four years of blood draw. We also assay plasma samples from an additional 223 cancer patients, plus 200 primary tumor and normal tissues. We show that PanSeer detects five common types of cancer in 88% (95% CI: 80-93%) of post-diagnosis patients with a specificity of 96% (95% CI: 93-98%), We also demonstrate that PanSeer detects cancer in 95% (95% CI: 89-98%) of asymptomatic individuals who were later diagnosed, though future longitudinal studies are required to confirm this result. These results demonstrate that cancer can be non-invasively detected up to four years before current standard of care.