PO.PR01.02 · 预防研究
用于早期检测结直肠癌的多组学液体活检
A multi-omic liquid biopsy for the earlier detection of colorectal cancer
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景:结直肠癌(CRC)的及时诊断和干预对于改善患者结局和限制疾病进展至关重要。对平均风险人群进行筛查对于在更早、更易治疗的阶段发现肿瘤至关重要。然而,目前对现有筛查项目的依从性仍不理想。液体活检代表了粪便检测的一种有前景的替代方案,可能在优化CRC检测和诊断路径中发挥关键作用。
方法:本研究在美国多个临床中心招募了957名患者:48例CRC、157例晚期癌前病变(APL)、331例非晚期病变(NAL)以及421例结肠镜检查结果为阴性的患者。血液采集于患者预定结肠镜检查之前,或手术切除及任何抗癌治疗之前。Streck血浆样本通过Dxcover® 液体活检平台进行分析,并使用机器学习算法进行分类。
结果:当将CRC与所有其他组进行分类时,受试者工作特征曲线生成的曲线下面积值为0.95,检测的敏感性和特异性分别为90%和89%。诊断模型准确预测了75%的I期(3/4)、100%的II期(15/15)、93%的III期(14/15)和100%的IV期(6/6)CRC。对于晚期结直肠肿瘤模型,检出了29%的APL。
结论:一种对早期结直肠癌具有高敏感性的简单血液检测可显著改善患者结局。随着持续的开发,该液体活检有望对CRC的早期检测产生实质性影响。
查看英文原文 English abstract
Background: Timely diagnosis and intervention in colorectal cancer (CRC) are critical to improving patient outcomes and limiting disease progression. Screening of average-risk individuals is essential for detecting tumors at an earlier, more treatable stage. However, adherence to current screening programs remains suboptimal. Liquid biopsies represent a promising alternative to stool-based tests and may play a key role in optimizing CRC detection and diagnostic pathways.
Methods: In this study, 957 patients were recruited across various clinical sites in the USA: 48 CRC, 157 advanced precancerous lesions (APL), 331 non-advanced lesions (NAL) and 421 with a negative colonoscopy diagnosis. Blood was obtained from patients either prior to scheduled colonoscopy or before surgical resection and any anti-cancer therapies. Streck plasma samples were analyzed by the Dxcover® Liquid Biopsy Platform and classified with machine learning algorithms.
Results: When CRC was classified against all other groups, the receiver operating characteristic curve generated an area under the curve value of 0.95, and test sensitivity and specificity were 90% and 89%, respectively. The diagnostic model accurately predicted 75% of stage I (3/4), 100% of stage II (15/15), 93% of stage III (14/15) and 100% of stage IV (6/6) CRCs. For the advanced colorectal neoplasia model, 29% of APL were detected.
Conclusion: A simple blood test with high sensitivity for early-stage colorectal cancer could significantly enhance patient outcomes. With continued development, this liquid biopsy has the potential to make a substantial impact on the early detection of CRC.
利益披露 Disclosure
J. M. Cameron,
Dxcover Ltd Employment.
H. J. Butler,
Dxcover Ltd. Employment, g., Board of Directors, non-salaried role).
D. S. Palmer,
Dxcover Ltd. Employment, g., Board of Directors, non-salaried role).
R. G. McHardy,
Dxcover Ltd. Employment.
A. Sala,
Dxcover Ltd. Employment.
M. J. Baker,
Dxcover Ltd. Employment, g., Board of Directors, non-salaried role).