循环游离DNA总量升高伴随癌症相关甲基化信号富集并提升多癌种检测灵敏度
Rising cell-free DNA level tracks cancer-associated methylation signal and improves multicancer detection
摘要
该研究基于43家医院1480例初治受试者(含14种癌症、良性疾病与健康对照),分析血浆游离DNA(ccfDNA)总量与癌症相关DNA甲基化信号的关系。结果显示,随ccfDNA总量升高,携带癌症相关甲基化特征的片段反而富集而非被稀释,且该现象独立于癌种、分期及人口学与临床技术协变量;ccfDNA对甲基化信号变异的解释力超过疾病分期。随ccfDNA浓度升高,各分期内检出灵敏度均提高(I期从0.55升至0.85,II期从0.59升至0.86),良性病变亦有类似趋势。作者提示ccfDNA浓度可作为独立于分期的分层变量,用于癌症检测试验的基准评估。
原文摘要
Cancer patients carry more circulating cell-free DNA (ccfDNA)—small DNA fragments shed into the blood—than healthy people. Most of this excess comes not from the tumor itself but from immune cells, suggesting that it would simply dilute the much smaller amount of tumor-derived DNA in a blood sample. Using a study of 1,480 previously untreated participants across 43 hospitals—including patients with 14 cancer types spanning all stages, patients with benign growths, and healthy volunteers—we show the opposite: as total ccfDNA rises, it becomes enriched, not diluted, in fragments carrying cancer-associated DNA methylation signatures, independent of cancer type, disease stage, and a broad panel of demographic, clinical, and technical covariates. In fact, total ccfDNA explains more variance in cancer-associated methylation signal than the disease stage itself. This basic biological finding suggests a coupling between immune cell activity and tumor methylation. It also has a practical implication: we show that rising ccfDNA concentration is associated with higher cancer detection sensitivity, even within disease stages and particularly in early-stage disease—stage I sensitivity varied from 0.55 in the lowest ccfDNA concentration tertile to 0.85 in the highest, and stage II from 0.59 to 0.86. This suggests that ccfDNA concentration should be considered as a stage-independent stratification variable for benchmarking cancer-detection tests. Interestingly, similar behavior was observed in patients with symptomatic benign lesions, suggesting a broader biological response to abnormal tissue growth and not something unique to malignancy.
推荐理由:PNAS大样本(1480例、43家中心)研究提出“ccfDNA升高伴随肿瘤甲基化信号富集”的反直觉结论,对液体活检的设计与分层有方法学价值;但研究对象为肿瘤患者,与生殖医学、ART及胚胎多组学无直接交集,对生殖领域读者仅为方法学借鉴。
文献解读
尚未生成。该条目分数达到自动解读阈值,下次流水线运行时会自动生成;