title: Quantification of Circulating Free DNA as a Diagnostic Marker in Gall Bladder Cancer.
abstract: Gall bladder Carcinoma (GBC) is the fifth most common cancer of the digestive tract and frequently diagnosed in late stage of disease. Estimation of circulating free DNA (cfDNA) in serum has been applied as a "liquid biopsy" in several deep seated malignancies. Its value in diagnosis of gall bladder carcinoma has not been studied. The present study was designed to assess the role of cfDNA in the diagnosis of GBC and correlate levels with the TNM stage. Serum was collected from 34 patients with GBC and 39 age and sex matched controls including 22 cholecystitis and 17 healthy individuals. Serum cfDNA levels were measured through quantitative polymerase chain reaction (qPCR) by amplification of β-globin gene. Performance of the assay was calculated through the receiver operating characteristic (ROC) curve. The cfDNA level was significantly lower in healthy controls and cholecystitis (89.32 ± 59.76 ng/ml, 174.21 ± 99.93 ng/ml) compared to GBC (1245.91 ± 892.46 ng/ml, p = <0.001). The cfDNA level was significantly associated with TNM stage, lymph node involvement and jaundice (0.002, 0.027, and 0.041, respectively). Area under curve of ROC analysis for cancer group versus healthy and cholecystitis group was 1.00 and 0.983 with sensitivity of 100 %, 88.24 % and specificity of 100 % respectively. Quantitative analysis of cfDNA may distinguish cholecystitis and gall bladder carcinoma and may serve as new diagnostic, noninvasive marker adjunct to imaging for the diagnosis of GBC.
authors.affiliation: Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India.
authors.forename: Swati
authors.initials: S
authors.lastname: Kumari
authors.affiliation: Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Tewari
authors.affiliation: Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India. drnuzhathusain@hotmail.com.
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Husain
authors.affiliation: Department of Surgical Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India.
authors.forename: Akash
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Department of Gastrosurgery, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India.
authors.forename: Anshuman
authors.initials: A
authors.lastname: Pandey
authors.affiliation: Department of Surgical Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, U.P, Lucknow, 226010, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Department of Biosciences, Integral University, U.P, Lucknow, 226026, India.
authors.forename: Mohtashim
authors.initials: M
authors.lastname: Lohani
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D002764:Cholecystitis / Q000097:blood / Q000473:pathology; D004247:DNA / Q000097:blood* / Q000235:genetics; D004273:DNA, Neoplasm / Q000097:blood* / Q000235:genetics; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood* / Q000235:genetics* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D004247:DNA
keywords: Circulating free DNA; DNA quantification; Gall bladder cancer; Real time PCR (qPCR)