A pilot study on the use of cerebrospinal fluid cell-free DNA in intramedullary spinal ependymoma.

A pilot study on the use of cerebrospinal fluid cell-free DNA in intramedullary spinal ependymoma.
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DOI:
10.1007/s11060-017-2557-y
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发表时间:
2017-10
影响因子:
3.9
通讯作者:
Hayden Gephart M
Hayden Gephart M
中科院分区:
医学2区
文献类型:
--
作者:
Connolly ID;Li Y;Pan W;Johnson E;You L;Vogel H;Ratliff J;Hayden Gephart M

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脑脊液 (CSF) 是中枢神经系统肿瘤无细胞 DNA (cfDNA) 的一个有前景的来源。基于脑脊液的液体活检可以避免对风险较高的组织活检的需要,并可作为监测肿瘤复发或治疗反应的一种手段。脊髓室管膜瘤最常见于成人,积极切除必须与邻近正常组织损伤的风险之间取得微妙的平衡。在次全切除的患者中,通常会发生复发。与患者脊髓室管膜瘤突变谱相匹配的基于脑脊液的液体活检可能比监测 MRI 更敏感,但其对于脊髓肿瘤的效用尚未得到很好的表征。在这项研究中,我们从三名患有 WHO II 级髓内脊髓室管膜瘤的成年患者中收集了匹配的血液、肿瘤和脑脊液样本。我们对匹配的肿瘤和正常 DNA 进行了全外显子组测序,以设计用于肿瘤和野生型突变的 Droplet Digital™ PCR (ddPCR) 探针。然后,我们通过对提取的 cfDNA 进行 ddPCR 来询问 CSF 样本中肿瘤来源的 cfDNA。在我们队列的脑脊液中没有可靠地检测到肿瘤 cfDNA。髓内脊髓肿瘤的解剖隔离和低级别可能限制了脑脊液液体活检的作用。
Cerebrospinal fluid (CSF) represents a promising source of cell-free DNA (cfDNA) for tumors of the central nervous system. A CSF-based liquid biopsy may obviate the need for riskier tissue biopsies and serve as a means for monitoring tumor recurrence or response to therapy. Spinal ependymomas most commonly occur in adults, and aggressive resection must be delicately balanced with the risk of injury to adjacent normal tissue. In patients with subtotal resection, recurrence commonly occurs. A CSF-based liquid biopsy matched to the patient’s spinal ependymoma mutation profile has potential to be more sensitive then surveillance MRI, but the utility has not been well characterized for tumors of the spinal cord. In this study, we collected matched blood, tumor, and CSF samples from three adult patients with WHO grade II intramedullary spinal ependymoma. We performed whole exome sequencing on matched tumor and normal DNA to design Droplet Digital™ PCR (ddPCR) probes for tumor and wild-type mutations. We then interrogated CSF samples for tumor-derived cfDNA by performing ddPCR on extracted cfDNA. Tumor cfDNA was not reliably detected in the CSF of our cohort. Anatomic sequestration and low grade of intramedullary spinal cord tumors likely limits the role of CSF liquid biopsy.
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