Isifundo Sokucwaninga Okuhleliwe

Muva nje, i-jama oncology (uma 33.012) Ishicilele umphumela obalulekile wokucwaninga [1] Iqembu likaProf. Cai Guo-Ring Disseliopy of Shanghai Jiao Tompion University kanye no-Prof Wang Diology kanye ne-Depy Designication yesigaba I ku-III TOARCE nge-III TOLELAL CORCE ngezikhula ezijikelezayo I-DNA methylation kanye nengozi enobungozi) ". Lolu cwaningo lucwaningo lokuqala lwe-multicententer emhlabeni ukufaka i-PTD-based tydna ye-CTDNA Multigene Methylution Technology kanye nokuqapha kwezobuchwepheshe okusebenzayo, okulindeleke ukuthi kuthuthukiswe kakhulu ekusetshenzisweni kwezobuchwepheshe kwezobuchwepheshe, okulindeleke ukuthi kuthuthukiswe kakhulu nokusinda kwesiguli kanye nekhwalithi yempilo. Lolo cwaningo luphinde lwahlolwa kakhulu yi-Journal kanye nabahleli balo, futhi lwaluhlelwe njengephepha lokuncoma elibalulekile kulolu daba, noProfessor juan Ruiz-bañobre waseSpain noProfessor Ajay Goel abavela e-United States bamenywa ukuthi babubuke. Lolo cwaningo luphinde lwabikwa nguGenomeWeb, abezindaba eziholayo ze-biomedical e-United States.

Umdlavuza we-Colorectal (CRC) yisimila esivamile esibi sephakethe lesisu eChina. I-2020 I-Agency Yezizwe Yokucwaninga nge-Cancer (IIRC) Idatha ikhombisa ukuthi amacala amasha angu-555,000 e-Akhawunti ka-China cishe ngo-1/3 womhlaba, ngesilinganiso sezehlakalo agxumela endaweni yesibili yomdlavuza eChina; I-286,000 yokufa kwabantu abazofa cishe ngo-1/3 womhlaba, ibeka njengembangela yesihlanu evame kakhulu yokufa komdlavuza eChina. Imbangela yesihlanu yokufa eChina. Kuyaphawuleka ukuthi phakathi kweziguli ezitholakele, izigaba ze-TNM i, ii, i-III no-IV zingu-18.6%, 30,7%, 30,2% ngokulandelana. Bangaphezu kuka-80% ezigulini eziphakathi nendawo futhi sekwephuzile, futhi ama-44% awo ane-metastaset kanyekanye noma ama-heterochronionic akude esibindini nasemaphaphuzwini, aphazamisa impilo yabahlali bethu futhi abeke impilo esindayo yezenhlalo kanye nomnotho. Ngokwezibalo zeNational Cancer Center, ukwanda okuphakathi konyaka kwezindleko zokwelashwa komdlavuza weCleectal eChina cishe ngo-6.9% kuya ku-9.2% weziguli kungakapheli ama-60% wemali engenayo yomndeni. Iziguli ezinomdlavuza zihlushwa lesi sifo futhi nangaphansi kwengcindezi enkulu yezomnotho [2].
Amaphesenti angamashumi ayisishiyagalolunye wezilonda zomdlavuza ezinombala angasuswa ngokuhlinzwa, futhi ama-tumor atholakala ekuqaleni, kukhuphuka izinga eliphakeme lokusinda kweminyaka emihlanu ngemuva kokuvuselelwa kabusha kwemininingwane, kepha isilinganiso sokuphindaphinda okujwayelekile ngemuva kokuvuselelwa kabusha kwama-30%. Amanani okusinda weminyaka emihlanu asemncedweni wamaShayina ku-90.1%, 72.6%, 53.8% kanye ne-10,4% ngezigaba I, ii, i-IV, ngokulandelana.
Isifo esisezingeni eliphansi (MRW) siyimbangela enkulu yokuphindaphinda kwesimila ngemuva kokwelashwa okukhulu. Eminyakeni yamuva nje, ubuchwepheshe bokutholwa kwe-MRD bokutholwa buthuthukile ngokushesha, futhi izifundo ezimbalwa ezisindayo zokuhlola kanye nokungenelela zikuqinisekisile ukuthi isimo se-MRD se-MRD singakhombisa ubungozi bokuphindwa komdlavuza we-colouperative. Ukuhlolwa kwe-CTDNA kunezinzuzo zokungabi nalutho, okulula, okusheshayo, ngokufinyeleleka okuphezulu kwesampula kanye nokunqoba i-tumor heterogeneity.
Imihlahlandlela ye-US NCCN yomdlavuza wekoloni kanye nemihlahlandlela ye-CS CHINESER CSCE yomdlavuza we-Colouperal womabili ukuthi ngokukhetha ubungozi be-postrooperative turrence, Ukuhlolwa kweCTDNATE CHEBTOTORAPY kumdlavuza wekoloni kanye neziguli ze-III colon. Kodwa-ke, izifundo eziningi ezikhona zigxile ekuguqukeni kwe-CTDNA ngokusekelwe kubuchwepheshe obusezingeni eliphezulu (i-NGS), elinenqubo eyinkimbinkimbi, isikhathi eside, kanye nezindleko eziphakeme [3], ngokuntuleka okuncane kweziguli ezinomdlavuza.
Endabeni yeziguli ezinomdlavuza we-STATE III, kubiza ama-CTDNA asuselwa ku-CTDNA ashukumisayo afinyelela ku- $ 10,000 ukuze avakashelwe ama- $ 10,000 afinyelela kumaviki amabili. Ngokuhlolwa kwe-multigene methylation kulolu cwaningo, iColonaiq®, iziguli zingaba nokuqapha i-CTDNA ye-CTDNA ngeshumi kwezindleko futhi zithole umbiko ezinsukwini ezimbili.
Ngokusho kwamacala amasha angama-560,000 omdlavuza we-colorectal eChina unyaka nonyaka, iziguli zomtholampilo ikakhulukazi ezinomdlavuza weSiteji II - I-III yemibala yomdlavuza (inani elingaba ngu-70% lomdlavuza oshukumisayo lifinyelela izigidi zabantu unyaka nonyaka.
Kuyabonakala ukuthi imiphumela yocwaningo inokubaluleka okubalulekile kwesayensi nokusebenzayo. Ngokusebenzisa izifundo ezinkulu zemitholampilo ezingaba khona, kuqinisekisile ukuthi ubuchwepheshe be-PTDNA busekelwe egazini le-CTDNA Multigene Methylution Bungasetshenziselwa ukubikezela komdlavuza womdlavuza we-Colorectal kanye nokuhamba kwesikhathi nokusebenza izindleko, umuthi ovumelanayo, uvumela kangcono umuthi ongcono wokuthola umdlavuza. Lolu cwaningo lususelwa kuColonaiq®, ukuhlolwa kwe-multi-gene methylation yomdlavuza we-colorectal athuthukiswe kuKuny, inani elilinganiselwe lokuhlolwa komtholampilo ekuhlolweni kokuqala nokuxilongwa seliqinisekisiwe ngocwaningo oluphakathi nemitholampilo.
I-Gastroenterology (IF33.88), iphephabhuku eliphakeme lamazwe omhlaba emkhakheni wezifo ze-gartaintestinal ngo-2021, elibike ukusebenza kahle kwe-kongran e-FUDAN University nezinye izikhungo zezokwelapha ezinobudlova kanye nokuxilongwa kwangaphambili komdlavuza wokuqala, futhi Kuqale kuhlolwe futhi kuhlolisise uhlelo lokusebenza olungaba khona ekuqaphelweni kwe-Prognosis komdlavuza we-Colorectal.

Ukuqhubeka nokuqinisekisa ukusetshenziswa komtholampilo kwe-CTDNA methylation engozini yokuhlukaniswa kwengozi, ukuqondisa izinqumo zokwelashwa kanye nokuqashwa komdlavuza we-STEAT I-III aqukethe umdlavuza we-Stage I-I-III enesiteji se-STEATIcal I-Point (Isonto elinye ngemuva kokuhlinzwa, nasekwelashweni okuhlangenwe nakho kwe-postoperative, kanye nokwelashwa kwe-postoperative admaperant, kanye nokwelashwa kwe-postoperative admaperant kwezokwelapha ezinamandla Ukuhlolwa kwegazi CTDNA.
Okokuqala, kwatholakala ukuthi ukuhlolwa kwe-CTDNA kungabikezela ubungozi bokuphindelela ezigulini ezinomdlavuza wezemibalaliso kusenesikhathi, ngokusebenza ngokuhlaziya kanye nokuqala. Iziguli ze-CTDNA ezinobuhlakani zibe namathuba aphezulu aphezulu wokuphindaphindwa okusebenzayo kuneziguli ezingabasebenzi ze-CTDNA-ezingezinhle (22.0%> 4.7%). Ukuhlolwa kokuqala kwe-CTDNA kusabikezele ubungozi bendabuko: inyanga eyodwa ngemuva kokuvuselelwa kabusha kwe-radical, iziguli ezinhle ze-CTDNA zazingama-17,5 amathuba okuvuselela iziguli ezingezinhle; Iqembu liphinde lathola ukuthi kuhlangene i-CTDNA nokwenza umsebenzi othuthukisiwe kancane ekutholeni kabusha (AUC = 0.849), kepha umehluko wawungabalulekanga umahluko we-CTDNA (AUC = 0.839).
I-Clinical Stial ihlanganiswe nezici zobungozi okwamanje isisekelo esiyinhloko sokuhlukaniswa kwengozi yeziguli zomdlavuza, nakwisibalo esikhulu samathuluzi asaqhubeka nokuvuselelwa kwamathuluzi angcono kakhulu kanye nokwelashwa okungaphansi kokwelashwa emtholampilo. Ngokusekelwe kulokhu, iqembu lihlukanise iziguli ezinomdlavuza weStage III emaqenjini ahlukene asuselwa ekuhlolweni kwengozi yomtholampilo ngokususelwa ekuhlolweni kwengozi yomtholampilo (ingozi enkulu (T1 / N2) nesikhathi esiphansi sokwelashwa (izinyanga ezi-3/6). Ukuhlaziywa kwathola ukuthi iziguli ezisezingeni eliphakeme kakhulu leziguli ze-CTDNA zinesilinganiso esiphansi sokuphindaphinda uma zithola izinyanga eziyisithupha zokwelapha ezifanayo; Esigungwini esiphansi sengozi yeziguli ze-CTDNA, kwakungekho mehluko omkhulu phakathi komjikelezo we-Add Suptream Treatment Cycle kanye nemiphumela yeziguli; Ngenkathi iziguli ezingezinhle ze-CTDNA zazineziguli ezingcono kakhulu kuneziguli ezinhle ze-CTDNA kanye nesikhathi esingesihle sokuphindaphindwa (ama-Rfs); Isiteji I kanye nesigaba esiphansi sesigaba II umdlavuza we-colorectal zonke iziguli ezingezinhle ze-CTDNA azinazo ezengeziwe kungakapheli iminyaka emibili; Ngakho-ke, ukuhlanganiswa kwe-CTDNA ngezinto zemitholampilo kulindeleke ukuthi kuphinde kwenziwe kabusha ukuhlukaniswa kobungozi nokubikezela kangcono ukuvela.

Umdwebo 1. Ukuhlaziywa kwe-Plasma CTDNA ePom1 ukuze kutholwe kusenesikhathi kokuvela komdlavuza we-Colectal Cancer
Imiphumela eyengeziwe yokuhlolwa kwe-CTDNA ye-CTDNA ikhombise ukuthi ubungozi bokuphindaphinda buphakeme kakhulu ezigulini ezinokuhlonza ama-CTDNA ashukumisayo ngemuva kwezinyanga ezingama-20 ngaphambi kokucabanga (umfanekiso 3b), okunikeza ithuba lokucabanga kusenesikhathi ukutholwa kokuvela kwezifo kanye nokungenelela okufika ngesikhathi.

Umdwebo 2

"Inani elikhulu lezifundo zemithi yezemibuzo ehumusha umdlavuza we-coloructal lihola isiyalo, ikakhulukazi ukuhlolwa kwe-MRD-esekwe ku-MRD kukhombisa amandla amakhulu okuthuthukisa ukuhlukaniswa kobungozi bemibala evumayo, ukuqondisa izinqumo zokwelashwa kanye nokuqapha ukwelashwa kokuqala.

Inzuzo yokukhetha i-DNA methylation njengonoveli we-MRD umaki wokutholwa kokuguqulwa ukuthi ayidingi ukulungiswa kokulandelana kwegazi, futhi kugwema imiphumela emihle yokutholwa kwegazi okuvela ezicutshini ezijwayelekile, izifo ze-benign, kanye ne-hematopoieieitis.
Lolu cwaningo nezinye izifundo ezihlobene nokuqinisekisa ukuthi ukuhlolwa kwe-MRD-based MRD kuyinto ebaluleke kunazo zonke ezimele engozini yokuphindaphindwa komdlavuza we-Stage I-III umdlavuza wengozi obaluleke kakhulu ngemuva kokuhlinzwa komdlavuza we-Stage I-III imibala yomdlavuza.
Insimu ye-MRW ivela ngokushesha ngenqwaba yezindlela ezintsha, ezibucayi kakhulu futhi eziqondile ezisuselwa ku-Epigenetics (i-DNA methylation kanye ne-depecredmics) kanye nokulandelana okuhlosiwe okujulile noma ukulandelana okujulile). Silindele ukuthi iColonaiQ® iqhubeka nokuhlela izifundo ezinkulu zemitholampilo futhi ingaba yinkomba entsha yokuhlolwa kwe-MRD okuhlanganisa ukufinyeleleka, ukusebenza okuphezulu nokufinyeleleka futhi kungasetshenziswa kabanzi ekusebenzeni kwemitholampilo. "
Ukunqubekela phambili
1 Moo S humushe d, han l, zhou h h h h h, wang y, buo w, wang y, buo w, wang y, buo w, wang y, buo w, bang y, buo w, wang y, bang y, buno a, wang y, buno z, bang z, buno g. Jama oncol. 2023 APR 20.
[2] "Umthwalo wesifo umdlavuza we-colorectal kubantu baseChina: Ngabe sekushintshile eminyakeni yamuva nje? , I-Chinese Journal of Epidemiology, Vol. 41, No. 10, Okthoba 2020.
[3] Tarazona n, Gimeno-Valiente f, Gambardella V, et al. Kubhekiswe ukulandelana kwesizukulwane esiseduze kwesizukulwane se-turnating-Tumera PRA ukulandelela isifo esisele esincane emdlavuza wekoloni olwenziwe endaweni. Ann Oncol. Nov 1, 2019; 30 (11): 1804-1812.
. Umdlavuza uphathe kabusha i-Rev. 2019; 75: 1-11.