Circulating cell-free DNA as a promising biomarker in patients with gastric cancer: diagnostic validity and significant reduction of cfDNA after surgical resection

Abstract

PurposeThe aim of this study is to determine whether levels of circulating free DNA (cfDNA) increase according to cancer progression, whether they are restored after surgical resection, and to evaluate cfDNA in gastric cancer patients as a useful biomarker.MethodsA case-control study design was used. Thirty gastric cancer patients and 34 healthy subjects were enrolled from two hospitals in South Korea. The plasma cfDNA of patients with gastric cancer were obtained before surgery and 24 hours after surgery, and then analyzed by a quantitative, real-time polymerase chain reaction. Plasma samples were also obtained from the control group.ResultsThe mean levels of cfDNA in the healthy control group, patients with early gastric cancer, and with advanced gastric cancer were 79.78 ± 8.12 ng/mL, 106.88 ± 12.40 ng/mL, and 120.23 ± 10.08 ng/mL, respectively (P < 0.01). Sensitivity was 96.67% and specificity was 94.11% when the cutoff value was 90 ng/mL. Variables representing the tumor burden such as tumor size, T stage, TNM stage, and curative resection are also associated with the levels of cfDNA. The levels of cfDNA in the 24-hour-after-surgery group decreased significantly (112.17 ± 13.42 ng/mL vs. 77.93 ± 5.94 ng/mL, P < 0.001) compared to the levels of cfDNA in the preoperation group.ConclusionThe changes in the levels of cfDNA can act as reliable biomarkers to detect cancer early, to predict tumor burden, estimate curative resection and even prognosis.

Post surgery circulating free tumor DNA is a predictive biomarker for relapse of lung cancer

“…The cfDNA in plasma from patients with cancer originates from normal nonmalignant cells, as well as necrotic and apoptotic tumor cells; but neither the origin nor the fate of the circulating DNA is fully understood [39,[50][51][52]. A previous study has shown a correlation between quantitative cfDNA levels and tumor-specific KRAS and EGFR mutations in plasma, which triggered us to hypothesize that increasing levels of cfDNA in patients with cancer are primarily of tumor origin [44,[53][54][55][56].…”

The role of total cell-free DNA in predicting outcomes among trauma patients in the intensive care unit: a systematic review

“…In recent years cell-free DNA (cfDNA) has become increasingly used as a clinical and noninvasive biomarker in the fields of cancer [1–3], pre-natal diagnostics [4], organ transplantation [5], and in several emergency conditions [6–8]. cfDNA, defined as extracellular DNA circulating freely in the blood, can be further subcategorized to circulating mitochondrial DNA (mtDNA) and circulating nuclear DNA (nDNA).…”

Circulating Tumor DNA as a Liquid Biopsy for Cancer

“…Several reported studies showed significant differences in the amounts of plasma DNA isolated from healthy individuals, patients with benign disease, and cancer patients. Although some studies revealed significantly higher concentrations of cfDNA in cancer patients and that simple quantification of cfDNA can confirm the presence of cancer or disease-free status and relapse after curative surgery (40,41 ), numerous other studies demonstrate that solely the amount of cfDNA is not a useful diagnostic tool and that the utility of cfDNA is limited without knowledge of tumor mutations (42,43 ). A study that analyzed total plasma DNA concentrations and tumorspecific KRAS mutations in CRC patients showed that a higher amount of tumor-specific fragments and that a higher number of CTCs were linked to biphasic size distributions of plasma DNA fragments (Fig.…”