Prognostic value of a novel biomarker combining DNA ploidy and tumor burden score for initially resectable liver metastases from patients with colorectal cancer.
Prognostic value of a novel biomarker combining DNA ploidy and tumor burden score for initially resectable liver metastases from patients with colorectal cancer.
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DOI：
10.1186/s12935-021-02250-x
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发表时间：
2021-10-23
影响因子：
5.8
通讯作者：
Wu X
中科院分区：
文献类型：
--
作者：
Peng J;Li W;Fan W;Zhang R;Li X;Xiao B;Dong Y;Wan D;Pan Z;Lin J;Wu X
结直肠癌肝转移（CRLM）尚未被确定为一个统一的疾病实体，由于转移性疾病的严重程度和肿瘤的侵袭性的差异。一个特定的预后风险亚组的筛选是迫切需要的。本研究旨在探讨DNA倍体、间质分数和核分型对CRLM患者初次可切除肝转移的预后价值。选择2006年至2018年在中山大学肿瘤防治中心接受根治性肝切除术的139例首次可切除CRLM患者进行分析。采用自动数字成像系统对肝转移瘤的DNA倍体、间质分数和核分型进行评价。采用Kaplan-Meier法和考克斯回归模型分析无复发生存期（RFS）和总生存期（OS）。在多变量分析中，DNA倍体被确定为RFS的独立预后因素（HR，2.082; 95% CI 1.053-4.115; P = 0.035），而间质肿瘤分数和核分型不是显著的预后因素。根据新参数结合肿瘤负荷评分（TBS）和DNA倍性分层的低、中、高风险组中，观察到3年RFS存在显著差异（72.5% vs. 63.2% vs. 37.3%，P = 0.007）。接受辅助化疗的高危组的3年RFS率显著优于未接受辅助化疗的高危组（46.7% vs. 24.8%; P = 0.034）。我们的研究表明，肝转移瘤的DNA倍体是肝切除术后最初可切除的CRLM患者的独立预后因素。DNA倍体和TBS的结合可能有助于将患者分为不同的复发风险组，并可能指导患者的术后治疗。在线版本包含补充材料，可通过10.1186/s12935-021-02250-x获得。
Colorectal cancer liver metastases (CRLM) has not been identified as a unified disease entity due to the differences in the severity of metastatic disease and tumor aggressiveness. A screen for specific prognostic risk subgroups is urgently needed. The current study aimed to investigate the prognostic value of DNA ploidy, stroma fraction and nucleotyping of initially resectable liver metastases from patients with CRLM. One hundred thirty-nine consecutive patients with initially resectable CRLM who underwent curative liver resection from 2006 to 2018 at Sun Yat-sen University Cancer Center were selected for analysis. DNA ploidy, stroma fraction and nucleotyping of liver metastases were evaluated using automated digital imaging systems. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox regression models. DNA ploidy was identified as an independent prognostic factor for RFS (HR, 2.082; 95% CI 1.053–4.115; P = 0.035) in the multivariate analysis, while stroma-tumor fraction and nucleotyping were not significant prognostic factors. A significant difference in 3-year RFS was observed among the low-, moderate- and high-risk groups stratified by a novel parameter combined with the tumor burden score (TBS) and DNA ploidy (72.5% vs. 63.2% vs. 37.3%, P = 0.007). The high-risk group who received adjuvant chemotherapy had a significantly better 3-year RFS rate than those without adjuvant chemotherapy (46.7% vs. 24.8%; P = 0.034). Our study showed that DNA ploidy of liver metastases is an independent prognostic factor for patients with initially resectable CRLM after liver resection. The combination of DNA ploidy and TBS may help to stratify patients into different recurrence risk groups and may guide postoperative treatment among the patients. The online version contains supplementary material available at 10.1186/s12935-021-02250-x.
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