title: Circulating Cell-Free DNA Levels Could Predict Oncological Outcomes of Patients Undergoing Esophagectomy for Esophageal Squamous Cell Carcinoma.
abstract: Circulating cell-free DNA (cfDNA) is a potential biomarker for cancer progression but its role is unclear in patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy. We investigated relationships between plasma cfDNA levels and clinicopathological parameters in ESCC patients. Eighty-one ESCC patients who received esophagectomy were enrolled. Plasma samples from these patients and 95 normal controls were collected. DNA copy numbers were measured by real-time quantitative PCR. Subjects were divided into two groups by cfDNA level. Clinicopathological data were collected retrospectively and relationships between cfDNA levels and clinical parameters were evaluated. The cfDNA level in normal controls ranged from 0-4157 copies/mL. The cfDNA level of 96.3% ESCC patients was higher than the cutoff value (2447.26 copies/mL) with a specificity of 94.1%. The mean cfDNA concentration was 5918 copies/mL in lower and 53,311 copies/mL in higher cfDNA groups. No correlations were found between clinicopathological factors and cfDNA levels except for lymphovascular invasion. Higher cfDNA levels were associated with tumor relapse (p= 0.018). Five-year disease-free survival (DFS) and overall survival (OS) rates were 34.7% and 33.8%, respectively. Patients with higher cfDNA levels had poorer DFS (p= 0.013). Patients with higher cfDNA levels had poorer OS, but not significantly (p= 0.164). Circulating cfDNA could be a biomarker for tumor relapse of ESCC with high sensitivity and specificity. Higher cfDNA levels were associated with tumor relapse and shorter DFS after esophagectomy in ESCC patients.
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. cchsieh2@vghtpe.gov.tw.|Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan. cchsieh2@vghtpe.gov.tw.|Department of Surgery, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. cchsieh2@vghtpe.gov.tw.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsieh
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan. hsuhs@vghtpe.gov.tw.|Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. hsuhs@vghtpe.gov.tw.
authors.forename: Han-Shui
authors.initials: HS
authors.lastname: Hsu
authors.affiliation: Department of Surgery, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. changsc@vghtpe.gov.tw.|Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei 11217, Taiwan. changsc@vghtpe.gov.tw.
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan. yjchen@ym.edu.tw.|Department of Life Sciences and Institute of Genome Sciences, National Yang-Ming University, Taipei 11221, Taiwan. yjchen@ym.edu.tw.|Department of Pediatrics, Renai Branch, Taipei City Hospital, Taipei 10629, Taiwan. yjchen@ym.edu.tw.
authors.forename: Yann-Jang
authors.initials: YJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood* / Q000235:genetics; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004247:DNA / Q000097:blood*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D004247:DNA
keywords: circulating cell-free DNA; esophageal squamous cell carcinoma; survival