Circulating cell-free DNA and its integrity as a prognostic marker for breast cancer

Abstract

The aim of our study was to look for alternative predictive biomarkers for breast cancer management in limited resource setup. A comprehensive analysis of circulating cell-free DNA (CCFD) in serum at baseline was performed to assess its prognostic potential. Quantitative polymerase chain reaction (qPCR) of ALU sequences using ALU115 and ALU247 primers was carried out in patients (N: baseline 148, postoperative 47) and 51 healthy controls. Mean serum DNA integrity, levels of ALU 247 and levels of ALU 115 were significantly higher in patients than in healthy females. No significant differences were observed in the levels ALU 247 and ALU 115 between stage IV and earlier stages of the disease. The DNA integrity was significantly higher in stage IV than earlier stages. A significant decrease in DNA integrity was observed after surgery (pre: 0.55 ± 0.23 vs post: 0.43 ± 0.30; P = 0.002) while no such change could be observed for ALU 247 and ALU 115. Baseline DNA integrity was significantly higher in relapsed patients than in patients who were free of disease (P = 0.005). Higher baseline DNA integrity was also indicated, though statistically not significant, in patients who died (P = 0.14). In contrast, ALU 247 and ALU 115 levels were decreased in died patients as compared to survivors (24.8 ± 34.80 vs 73.5 ± 170.83, P = 0.02 for ALU 247 and 41.0 ± 47.99 vs 159.5 ± 299.54, P = 0.005 for ALU 115). Baseline levels of ALU 115 and ALU 247 were lower in relapsed patients, though statistically not significant. In univariate analysis, the only clinic-pathological parameter associated with disease prognosis was tumor size. The hazards of 5-year overall mortality was 3.60 (95 % CI: 1.03 12.53, P = 0.03) among patients with lower baseline serum levels of CCFD (ALU 247 < 21 and ALU 115 < 41). Similarly the 4 year hazards for recurrence was 2.30 (95 % CI: 0.96 5.52, P = 0.05) among patients with higher DNA integrity. Baseline serum levels of CCFD and its integrity were found to be potential prognostic biomarkers in patients of primary breast cancer at our centre.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-015-1071-y) contains supplementary material, which is available to authorized users.

Value of circulating cell-free DNA analysis as a diagnostic tool for breast cancer: a meta-analysis

“…After full-text review, 20 studies [8, 10, 14, 29–35, 42–44, 48–50, 56–59] were excluded because they did not allow the calculation of sensitivity or specificity, included very rare indicators, or consisted of less than 10 breast cancer patients (Figure 1). …”

Circulating cell-free DNA integrity as a diagnostic and prognostic marker for breast and prostate cancers

“…Circulating cell-free DNA (ccfDNA) are degraded DNA fragments released into the blood stream [11][12][13] . Chronicling its discovery, Iqbal et al [14] states that, circulating cell-free DNA (cfDNA) in human plasma was rediscovered in 1966 by Tan et al [15] in autoimmune disorders and later by Leon et al [16] in 1977 in cancers after its initial discovery in 1948 by Mandel and Metais [17] . The source of ccfDNA in healthy individuals is solely by apoptosis, producing evenly sized shorter DNA fragments.…”

Circulating DNA as a Strong Multimarker Prognostic Tool for Metastatic Colorectal Cancer Patient Management Care

“…Thus, recent studies on the clinical application of ccfDNA have mainly focused on qualitative analysis such as the presence of mutations (5). The ccfDNA fragmentation level has been also investigated as a predictive tool for cancer progression (21)(22)(23).…”