鼻咽癌患者组织及血液中线粒体DNA D-loop区突变

目的:检测鼻咽癌患者线粒体DNA复制控制区(mtDNAD-loop)的突变情况。方法:以健康人血标本和鼻咽癌患者癌旁组织作为对照,对20例鼻咽癌组织样本及相应的血液样本的mtDNAD-loop区进行PCR扩增和直接测序分析。结果:在20份鼻咽癌组织样本中共发现312个核苷酸改变,其中293个为已知的多态性改变,4个为新的未记载过的多态性改变;9个肿瘤组织样本和相应的血标本中共发现15个突变;癌旁组织较多多态性变化,未检出突变;鼻咽癌的mtDNAD-loop区突变率为45%(9/20)。结论:血液中mtDNAD-loop的变异可能与鼻咽癌的易感性有一定的联系;本研究为寻找新的肿瘤基因诊断和肿瘤遗传易感性的标志物提供了依据。     

Significance of Cell-Free Epstein-Barr Virus DNA in Monitoring Prognosis of Nasopharyngeal Carcinoma

Objective  It has been reported that cell-free Epstein-Barr virus (EBV-DNA) in plasma was useful in diagnosing and monitoring nasopharyngeal carcinoma (NPC). The current study was designed to evaluate the significance of EBV-DNA in monitoring the prognosis of nasopharyngeal carcinoma and comparing its significance with that of plasma VCA/lgA and EA/lgA levels. Methods  E8V -DNA, VCA/lgA, and EA/lgA levels in plasma were determined in NPC patients with different prognosis after radiotherapy, including 30 distant metastatic patients, 22 local recurrence patients and 24 individuals with remission who had been followed-up for more than 2 years after treatment. EBV-DNA was determined using a real-time quantitative PCR system, and levels of VCA/lgA and EA/lgA were measured using standard immunofluorescence. In a cohort study, the indexes were determined after different radiation periods for the 20 new cases of nasopharyngeal carcinoma. Results  The median plasma EBV-DNA concentration was 135,100 copies/ ml (interquartile range: 5,525-1,003 750) in metastatic group, 20,500 copies/ ml (interquartile range: 0 -58,500) in the local recurrence group and 0 copies/ml (interquartile range: 0-0) in the continuous remission group (P< 0.05). The levels of VCA/lgA and EA/lgA showed no significant differences among the different groups. The high level of EBV-DNA concentration in the metastatic group was more than that in the local recurrence group. A level of 1,000,000 copies/ml of EBV DNA was an indication of distant metastasis of the NPC patients with a sensitivity of 27.3%. However, the sensitivity was 0 in the local recurrence group. For the 20 new patients, EBV -DNA concentration gradually decreased during the radiation period. Before radiation there were 32,050 copies/ml (interquartile range: 3,880-317,750), 0 copies/ml (interquartile range: 0-14 375) after a 40 Gy radiation dose and 0 copies/ml (interquartile range: 0-2940) after the radiation was finished (P< 0.05). However, the levels of VCA/lgA and EA/lgA showed no significant difference. Conclusion  Determination of plasma cell -free EBV -DNA level is more valuable than evaluation of VCA/lgA and EA/lgA for monitoring the prognosis of NPC patients.     

Significance of cell-free epstein-barr virus DNA in monitoring prognosis of nasopharyngeal carcinoma

Objective It has been reported that cell-free Epstein-Barr virus (EBV-DNA) in plasma was useful in diagnosing and monitoring nasopharyngeal carcinoma (NPC). The current study was designed to evaluate the significance of EBV-DNA in monitoring the prognosis of nasopharyngeal carcinoma and comparing its significance with that of plasma VCA/lgA and EA/lgA levels. Methods E8V -DNA, VCA/lgA, and EA/lgA levels in plasma were determined in NPC patients with different prognosis after radiotherapy, including 30 distant metastatic patients, 22 local recurrence patients and 24 individuals with remission who had been followed-up for more than 2 years after treatment. EBV-DNA was determined using a real-time quantitative PCR system, and levels of VCA/lgA and EA/lgA were measured using standard immunofluorescence. In a cohort study, the indexes were determined after different radiation periods for the 20 new cases of nasopharyngeal carcinoma. Results The median plasma EBV-DNA concentration was 135,100 copies/ ml (interquartile range: 5,525-1,003 750) in metastatic group, 20,500 copies/ ml (interquartile range: 0 -58,500) in the local recurrence group and 0 copies/ml (interquartile range: 0-0) in the continuous remission group (P< 0.05). The levels of VCA/lgA and EA/lgA showed no significant differences among the different groups. The high level of EBV-DNA concentration in the metastatic group was more than that in the local recurrence group. A level of 1,000,000 copies/ml of EBV DNA was an indication of distant metastasis of the NPC patients with a sensitivity of 27.3%. However, the sensitivity was 0 in the local recurrence group. For the 20 new patients, EBV -DNA concentration gradually decreased during the radiation period. Before radiation there were 32,050 copies/ml (interquartile range: 3,880-317,750), 0 copies/ml (interquartile range: 0-14 375) after a 40 Gy radiation dose and 0 copies/ml (interquartile range: 0-2940) after the radiation was finished (P< 0.05). However, the levels of VCA/lgA and EA/lgA showed no significant difference. Conclusion Determination of plasma cell -free EBV -DNA level is more valuable than evaluation of VCA/lgA and EA/lgA for monitoring the prognosis of NPC patients.     

Quantitative Extra Long PCR to Detect DNA Lesions in Patients Exposed to Low Doses of Diagnostic Radiation

Background: Radiation causes oxidative lesions and strand breaks in DNA of exposed cells. Extended lengthPCR is a reliable method for assessing DNA damage. Longer DNA strands with DNA damage are difficult to amplifycompared to smaller DNA strands by PCR. The present study was aimed to evaluate DNA damage caused by ionisingradiation exposure in therapeutic and diagnostic medicine. Materials and Methods: The study group comprised 50cases with low dose single exposure (LDS), low dose multiple exposure (LDM) and low dose angiography (LDA)which were compared with 25 high dose controls (HDC) and 25 controls with no exposure (NEC). Blood samples werecollected within 1 hour of radiation exposure. DNA was isolated using a kit based protocol, 50 ng aliquots of DNAwere used to amplify a long 13kbp DNA fragment of the β-actin gene by conventional PCR and band intensity wasthen quantified. Relative amplification was calculated and damage was expressed in terms of lesions per kilobase (kbp)by assuming a Poisson distribution. Result: Relative amplification was found to be 1.0, 0.87, 0.86, 0.72 and 0.69 withNEC, LDS, LDM, LDA and HDC groups, respectively. Cases undergoing angiography as well as high dose controlshad high values, compared to NEC. The lesions/kbp calculated for LDS was 0.13, for LDM 0.15, for LDA 0.32 andfor HDC 0.37 suggesting a linear increase in quantity with increasing radiation dose. Conclusion: DNA damage, evenat low doses of radiation can be assessed by quantitative extra long PCR.     

Regulation of DNA repair in hypoxic cancer cells

Emerging evidence indicates that the tumor microenvironmental stress of hypoxia can induce genetic instability in cancer cells. We and others have found that the expression levels of key genes within the DNA mismatch repair (MMR) and homologous recombination (HR) pathways are coordinately repressed by hypoxia. These decreases are associated with functional impairments in both MMR and HR repair under hypoxic conditions, and thus they represent a possible mechanistic explanation for the observed phenomenon of hypoxia-induced genetic instability. In parallel, studies also indicate that several DNA damage response factors are activated in response to hypoxia and subsequent reoxygenation, including ATM/ATR, Chkl/Chk2 and BRCA1. Taken together, these findings reveal that hypoxia induces a unique cellular stress response involving an initial, acute DNA damage response to hypoxia and reoxygenation, followed by a chronic response to prolonged hypoxia in which selected DNA repair pathways are coordinately suppressed. In this review, we discuss these pathways and the possible mechanisms involved, as well as the consequences for genetic instability and tumor progression within the tumor microenvironment.     

Marked dependence on growth state of backup pathways of NHEJ

PURPOSE: Backup pathways of nonhomologous end joining (B-NHEJ) enable cells to repair DNA double-strand breaks (DSBs) when DNA-PK-dependent NHEJ (D-NHEJ) is compromised. Recent evidence implicates growth signaling in the regulation of D-NHEJ. This study was intended to determine whether the ability to repair DSBs by B-NHEJ also depends on growth state. METHODS AND MATERIALS: LIG4(-/-) and wild type (WT) mouse embryo fibroblasts (MEFs) were used. Repair of DSBs was measured by pulsed-field agarose gel electrophoresis. G1 cells were selected by centrifugal elutriation. A plasmid assay was used to measure DNA end-joining activity in whole cell extracts. RESULTS: Wild-type MEFs efficiently repaired DSBs by D-NHEJ in either the exponential or plateau phase of growth. Because of their defect in ligase IV, which compromises D-NHEJ, LIG4(-/-) MEFs showed reduced repair capacity but were slowly able to rejoin a large proportion of DSBs via B-NHEJ. B-NHEJ was markedly reduced in the plateau phase of growth or at high radiation doses. Elutriated G1 cells from exponentially growing or plateau-phase LIG4(-/-) cultures showed a response similar to nonelutriated cells, ruling out that the effect simply reflects redistribution in the cell cycle. An in vitro assay, gauging the activity of B-NHEJ, showed a reduction in DNA end joining during the plateau phase that could be corrected by recombinant DNA ligase IIIalpha. CONCLUSIONS: Suppression of growth signaling markedly compromises DSB repair by B-NHEJ. This effect is associated with a reduction in DNA ligase III mediated DNA end joining.     

血浆 EB病毒游离 DNA检测对监测鼻咽癌患者预后的意义

背景与目的:有报道 , 测定血浆中的 EB病毒游离 DNA( EBV-DNA)的拷贝数可作为诊断及监测鼻咽癌患者病情变化的手段之一.本研究旨在评价血浆 EBV-DNA检测在鼻咽癌患者预后监测上的价值, 并进一步与 VCA/IgA、 EA/IgA进行比较.方法:比较鼻咽癌放疗后 30例远处转移患者、 22例局部复发患者、 24例无 瘤生存者血浆中 EBV-DNA、 VCA/IgA、 EA/IgA水平.分别应用荧光定量 PCR方法检测血浆 EBV-DNA水平,免疫酶法检测 VCA/IgA、 EA/IgA;前瞻性观察 20例初诊鼻咽癌患者放疗前、放疗剂量达 40 Gy时及放疗结束时上述指标的变化. 结果:放疗后各组不同预后患者的血浆 EBV-DNA含量的中位数有显著性差异, 远处转移组为 135 100 copies/ml(四分线区域 5 525～ 1 003 750 copies/ml) >局部复发组的 20 500(四分线区域 0～ 58 500 copies/ml) > 无瘤生存组的 0 copy/ml(四分线区域 0～ 0 copy/ml), P均 < 0.05. 远处转移组的血浆 EBV-DNA水平高者较多, 当阳性标准为 1 000 000 copies/ml时,诊断远处转移组的敏感性为 27.3%,而诊断局部复发组的敏感性为 0.0%,特异性均为 100.0%.在初诊患者放疗前、放疗剂量达 40 Gy时及放疗结束时, EBV-DNA水平逐渐降低,平均含量分别为 32 050 copies/ml(四分线区域 3 880～ 317 750 copies/ml)、 0 copy/ml(四分线区域 0～ 14 375 copies/ml)、 0 copy/ml(四分线区域 0～ 2 940 copies/ml), P均 < 0.05, 而 VCA/IgA、 EA/IgA的水平未见明显变化. 结论: 血浆 EBV-DNA检测可用于监测鼻咽癌患者预后,其价值明显优于 VCA/IgA、 EA/IgA.     

血卟啉衍生物（HPD）加光照对无细胞体系DNA合成的抑制作用

本文从腹水型肝癌细胞部分纯化了依赖于ＤＮＡ的ＤＮＡ聚合酶ａ，以热变性的小牛胸腺ＤＮＡ为模板，观察了ＨＰＤ的光敏效应对这－ＤＮＡ合成体系的影响。结果表明，单独的ＨＰＤ或光照对无细胞体系ＤＮＡ合成无细胞；而既用ＨＰＤ处理，又经光照后的ＤＮＡ合成系统表现出明显的抑制作用。此抑制作用呈显著的剂量和时间的依赖效应关系。ＨＰＤ的光敏反应与ＤＮＡ模板非竞争性地作用于酶。增加模板量不能使抑制作用逆转；而增加酶量可     

Relationship between plasma cell-free DNA (cfDNA) and prognosis of TACE for primary hepatocellular carcinoma

BackgroundOur study aims to investigate changes in cell-free DNA (cfDNA) concentration and integrity in primary hepatocellular carcinoma (PHC) patients before and after transcatheter arterial chemoembolization (TACE) treatment and their influence on the evaluation of prognosis of the disease.MethodsA total of 84 PHC patients admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from December 2016 to December 2017 were included as the study group, while 55 healthy people served as the control group. Plasma cfDNA concentration and integrity were determined using qRT-PCR. The correlation between cfDNA concentration/integrity and clinical characteristics of PHC patients were analyzed. A ROC curve was used to investigate the sensitivity and specificity of cfDNA as detection indices. Univariate and multivariate analyses were used to analyze factors affecting recurrence in PHC patients and compare recurrence-free survival (RFS) of PHC patients with high cfDNA expression and low cfDNA expression.ResultsPlasma cfDNA concentration and integrity were significantly higher in PHC patients before TACE treatment than in healthy people and significantly lower after treatment than before (P<0.05). The cfDNA concentration was significantly correlated with tumor size, lymph node metastasis, TNM stage, and BCLC stage, while cfDNA integrity was significantly correlated with tumor size, TNM stage, and BCLC stage (P<0.05). ROC results showed that the area under the curve (AUC) value of cfDNA concentration was the largest, with an optimal cut-off of 10.51 ng/mL. Multivariate regression analysis for COX showed that the TNM stage, cfDNA concentration, and AFP were independent risk factors that affected PHC patients’ survival.ConclusionsPlasma cfDNA concentration in PHC patients is more sensitive and specific than any other tumor marker. It is an independent risk factor for PHC patients treated with TACE. Therefore, it is hypothesized cfDNA is a potential biomarker for prognostic evaluation of PHC patients treated with TACE.     

ENVIRONMENTAL CARCINOGENIC POLYCYCLIC AROMATIC HYDROCARBONS: PHOTOCHEMISTRY AND PHOTOTOXICITY

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs) are a class of environmental contaminants that has long been of interest in the fields of organic chemistry, theoretical chemistry, physical chemistry, environmental science, toxicology, cancer research, and energy sciences. Concerning environmental science and cancer research, majority of the research has focused on the occurrence, environmental fate, degradation/remediation, chemical transformation, genotoxicity, metabolism and metabolic activation, DNA adduct formation, mutagenesis, and carcinogenesis. Although many books and reviews on these subjects have been published, PAH photochemistry and phototoxicity have received much less attention. Therefore, it is intended for this article to provide an up-to-date source of photochemical reaction, photo-transformation, and phototoxicity of PAHs and their oxygenated, nitrated, halogenated, and amino substituted derivatives on a molecular basis. A perspective for future work is also discussed.     

Circulating tumor DNA—From bench to bedside

In the era of personalized medicine, tumor sampling is paramount to enable the assessment of actionable molecular aberrations to help rationalize and guide treatment decisions. Longitudinal tracking of such aberrations may also be helpful to detect emerging drug resistance and to allow for timely modifications to ongoing therapies to improve patient outcomes. Nevertheless, tumor tissue sampling involves an invasive procedure with potential risks to patients and involves logistical challenges. As such, other less invasive and safer methods such as blood sampling for molecular profiling has been gaining traction. In this article, we discuss the concept of circulating tumor DNA, the technology platforms available for its interrogation, and its current applications in the clinic. We also envision how circulating tumor DNA may be applied at multiple time points along a patient’s cancer journey to guide diagnosis, prognostication, and therapeutic decisions.     

The promise and failures of epigenetic therapies for cancer treatment

Genetic mutations and gross structural defects in the DNA sequence permanently alter genetic loci in ways that significantly disrupt gene function. In sharp contrast, genes modified by aberrant epigenetic modifications remain structurally intact and are subject to partial or complete reversal of modifications that restore the original (i.e. non-diseased) state. Such reversibility makes epigenetic modifications ideal targets for therapeutic intervention. The epigenome of cancer cells is extensively modified by specific hypermethylation of the promoters of tumor suppressor genes relative to the extensive hypomethylation of repetitive sequences, overall loss of acetylation, and loss of repressive marks at microsatellite/repeat regions. In this review, we discuss emerging therapies targeting specific epigenetic modifications or epigenetic modifying enzymes either alone or in combination with other treatment regimens. The limitations posed by cancer treatments elicit unintended epigenetic modifications that result in exacerbation of tumor progression are also discussed. Lastly, a brief discussion of the specificity restrictions posed by epigenetic therapies and ways to address such limitations is presented.     

鼻咽癌组织线粒体DNA突变的研究

[目的]通过检测鼻咽癌组织中线粒体DNA(mitochodrial DNA,mtDNA)部分区域的突变,探讨mtDNA突变在人鼻咽癌发生中的作用.[方法]提取23例鼻咽癌组织及其同一患者外周血白细胞的总DNA,经PCR扩增mtDNA,产物直接测序测定mtDNA序列.[结果]23例鼻咽癌组织中8例(34.8%)发现33个突变,包括点突变27个,插入突变3个,缺失突变3个;这些突变分布于mtDNA序列中,27个mtDNA突变位于D-loop区,其中21个是属于基因库中的多态变化,6个为新发现的突变;另外6个mtDNA突变位于线粒体编码区.[结论]鼻咽癌组织线粒体DNA的D-loop区是一个高度多态性和突变性的区域,mtDNA的突变可能与鼻咽癌的发生有一定的联系,有望成为肿瘤诊断的分子标记.     

Aberrant DNA methyltransferase expression in pancreatic ductal adenocarcinoma development and progression

Background

Altered gene methylation, regulated by DNA methyltransferases (DNMT) 1, 3a and 3b, contributes to tumorigenesis. However, the role of DNMT in pancreatic ductal adenocarcinoma (PDAC) remains unknown.

Methods

Expression of DNMT 1, 3a and 3b was detected in 88 Pancreatic ductal adenocarcinoma (PDAC) and 10 normal tissue samples by immunohistochemistry. Changes in cell viability, cell cycle distribution, and apoptosis of PDAC cell lines (Panc-1 and SW1990) were assessed after transfection with DNMT1 and 3b siRNA. Levels of CDKN1A, Bcl-2 and Bax mRNA were assessed by qRT-PCR, and methylation of the Bax gene promoter was assayed by methylation-specific PCR (MSP).

Results

DNMT1, 3a and 3b proteins were expressed in 46.6%, 23.9%, and 77.3% of PDAC tissues, respectively, but were not expressed in normal pancreatic tissues. There was a co-presence of DNMT3a and DNMT3b expression and an association of DNMT1 expression with alcohol consumption and poor overall survival. Moreover, knockdown of DNMT1 and DNMT3b expression significantly inhibited PDAC cell viability, decreased S-phase but increased G1-phase of the cell cycle, and induced apoptosis. Molecularly, expression of CDKN1A and Bax mRNA was upregulated, and the Bax gene promoter was demethylated. However, a synergistic effect of combined DNMT1 and 3b knockdown was not observed.

Conclusion

Expression of DNMT1, 3a and 3b proteins is increased in PDAC tissues, and DNMT1 expression is associated with poor prognosis of patients. Knockdown of DNMT1 and 3b expression arrests tumor cells at the G1 phase of the cell cycle and induces apoptosis. The data suggest that DNMT knockdown may be a novel treatment strategy for PDAC.     

前列腺癌组织MVD、DNA倍体与其临床生物学行为的研究

 目的　探讨前列腺癌DNA倍体、微血管密度 (MVD)与癌分级、临床分期及预后的关系。方法　应用计算机图像分析技术、免疫组织化学 (SP)法 ,测定 30例前列腺癌 (PC)、30例前列腺增生症 (BPH)细胞核DNA倍体、MVD的变化。结果　随癌分化程度降低 ,DNA倍体增加 ,MVD升高 ,其差异有显著性 (P<0 .0 1) ;临床分期处于C、D期DNA倍体MVD高于A、B期者 (P <0 .0 1) ,其生存率亦变低 (P <0 .0 5 )。结论　DNA倍体、MVD可准确地反映PC的预后。DNA倍体与MVD间呈正相关关系。     

Prospective blinded study of somatic mutation detection in cell-free DNA utilizing a targeted 54-gene next generation sequencing panel in metastatic solid tumor patients

Sequencing of the mutant allele fraction of circulating cell-free DNA (cfDNA) derived from tumors is increasingly utilized to detect actionable genomic alterations in cancer.We conducted a prospective blinded study of a comprehensive cfDNA sequencing panel with 54 cancer genes. To evaluate the concordance between cfDNA and tumor DNA (tDNA), sequencing results were compared between cfDNA from plasma and genomic tumor DNA (tDNA). Utilizing next generation digital sequencing technology (DST), we profiled approximately 78,000 bases encoding 512 complete exons in the targeted genes in cfDNA from plasma. Seventy-five patients were prospectively enrolled between February 2013 and March 2014, including 61 metastatic cancer patients and 14 clinical stage II CRC patients with matched plasma and tissue samples. Using the 54-gene panel, we detected at least one somatic mutation in 44 of 61 tDNA (72.1%) and 29 of 44 (65.9%) cfDNA. The overall concordance rate of cfDNA to tDNA was 85.9%, when all detected mutations were considered. We collected serial cfDNAs during cetuximab-based treatment in 2 metastatic KRAS wild-type CRC patients, one with acquired resistance and one with primary resistance. We demonstrate newly emerged KRAS mutation in cfDNA 1.5 months before radiologic progression. Another patient had a newly emerged PIK3CA H1047R mutation on cfDNA analysis at progression during cetuximab/irinotecan chemotherapy with gradual increase in allele frequency from 0.8 to 2.1%. This blinded, prospective study of a cfDNA sequencing showed high concordance to tDNA suggesting that the DST approach may be used as a non-invasive biopsy-free alternative to conventional sequencing using tumor biopsy.     

Circulating tumor DNA-based molecular residual disease detection for treatment monitoring in advanced melanoma patients

Background

Immune checkpoint inhibitors (ICIs) have substantially improved overall survival in patients with advanced melanoma; however, the lack of biomarkers to monitor treatment response and relapse remains an important clinical challenge. Thus, a reliable biomarker is needed that can risk-stratify patients for disease recurrence and predict response to treatment.

Methods

A retrospective analysis using a personalized, tumor-informed circulating tumor DNA (ctDNA) assay on prospectively collected plasma samples (n = 555) from 69 patients with advanced melanoma was performed. Patients were divided into three cohorts: cohort A (N = 30), stage III patients receiving adjuvant ICI/observation; cohort B (N = 29), unresectable stage III/IV patients receiving ICI therapy; and cohort C (N = 10), stage III/IV patients on surveillance after planned completion of ICI therapy for metastatic disease.

Results

In cohort A, compared to molecular residual disease (MRD)-negative patients, MRD-positivity was associated with significantly shorter distant metastasis-free survival (DMFS; hazard ratio [HR], 10.77; p = .01). Increasing ctDNA levels from the post-surgical or pre-treatment time point to after 6 weeks of ICI were predictive of shorter DMFS in cohort A (HR, 34.54; p < .0001) and shorter progression-free survival (PFS) in cohort B (HR, 22; p = .006). In cohort C, all ctDNA-negative patients remained progression-free for a median follow-up of 14.67 months, whereas ctDNA-positive patients experienced disease progression.

Conclusion

Personalized and tumor-informed longitudinal ctDNA monitoring is a valuable prognostic and predictive tool that may be used throughout the clinical course of patients with advanced melanoma.     

DNA修复率与非霍奇金淋巴瘤应用含烷化剂联合化疗疗效的关系

目的 探讨非霍奇金淋巴瘤（NHL）患者外周血淋巴细胞（PBLC）的DNA修复率（DRR）与含烷化剂联合化疗疗效的关系。方法 采用单细胞凝胶电泳法检测30例NHL患者（肿瘤组）PBLC的DRR,并选取20例非肿瘤患者作对照（对照组）。肿瘤组接受含环磷酰胺联合方案化疗并于4个周期后评价疗效,分析肿瘤组和对照组PBLC在环磷酰胺暴露前与暴露且修复后的DRR水平,同时分析肿瘤组DRR与临床病理特征及含烷化剂联合化疗疗效的关系。结果 利用尾长（TL）（Z=4.464,P=0.000）和尾相（TM）（Z=3.828,P=0.000）检测肿瘤组PBLC的DRR均低于对照组（P<0.05）。肿瘤组PBLC的DRR与年龄、性别、ECOG评分、临床分期、LDH值、Ki 67增殖指数和是否饮酒均无关（P>0.05）。30例NHL患者中获CR 4例、PR 14 例、SD 10例和PD 2例,有效率为60.0%,疾病控制率为93.3%。以TL评价DRR提示DRR与化疗疗效呈负相关（r=-0.409,P=0.025）,以TM评价DRR提示DRR与化疗疗效无关（r=-0.224, P=0.234）。结论 NHL患者较非肿瘤患者DNA修复能力降低;DRR与NHL患者含烷化剂联合化疗近期疗效呈负相关。     

Super-ARMS 法检测云南地区非小细胞肺癌患者外周血中EGFR突变及其临床意义

目的：探讨使用超级扩增阻滞突变系统（Super-ARMS）法检测云南地区非小细胞肺癌（NSCLC）患者外周血中表皮生长因子受体（EGFR）基因突变与临床病理特征之间的关系。方法: 收集2017 年1 月到2018 年12 月云南省肿瘤医院分子诊断分中心共检测的222 例NSCLC患者外周血,以Super-ARMS法检测外周血浆中EGFR基因突变并分析其与临床病理特征的关系,同时分析影响EGFR突变的独立危险因素。结果: 222 例NSCLC患者的外周血浆中,EGFR基因突变阳性81 例、突变率为36.5%,其中19 号外显子缺失和L858R基因点突变最常见（占总突变的75.3%）。女性突变较男性高（45.9% vs 27.0%）;<60 岁患者突变率高于≥60 岁患者（43.2% vs 28.8%）（均P<0.05 或P<0.01）;无吸烟史、无根治性手术史、腺癌、晚期和无化疗史患者EGFR基因突变率较高(43.9% vs 21.6%,39.2% vs 21.2%,43.9% vs 4.8%,39.7% vs 23.3%、44.0% vs 23.5%)（P<0.05 或P<0.01）。多因素分析显示,年轻、无吸烟史、腺癌、无手术史是EGFR基因突变的独立危险因素（均P<0.01）。结论: 在云南地区NSCLC患者外周血浆中,年龄<60 岁、腺癌、不吸烟患者EGFR基因突变率更高,Super-ARMS法对肺癌患者外周血EGFR突变检测更灵敏。