Year :
2020
| Month :
March
| Volume :
14
| Issue :
3
| Page :
XC16 - XC19
Full Version
The Role of Circulating Tumour DNA as a Marker
of Adequate Resection in Oral Cancer and its
Correlation with Clinico-pathologic Parameters:
A Prospective Study
Published: March 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/43089.13593
Akhlak Husain, Ashish Singhal, Akash Agarwal, Rahat Hadi, Nuzhat Husain
1. Senior Resident, Department of Surgical Oncology, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
2. Professor, Department of Surgical Oncology, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
3. Professor, Department of Surgical Oncology, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
4. Professor, Department of Radiotherapy, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
5. Professor, Department of Pathology, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
Correspondence Address :
Dr. Ashish Singhal,
Professor, Department of Surgical Oncology, Dr RMLIMS, Lucknow, Uttar Pradesh, India.
E-mail: ashishpgi@yahoo.co.in
Abstract
Introduction: Oral Cavity Squamous Cell Carcinoma (OSCC) is prevalent worldwide. The genetic heterogeneity of this disease and the limitation of biopsy in selective mapping, made use of conventional biopsy sub-optimal for advanced molecular profiling. There is a lacuna for non-invasive tests which are easy to perform, helpful in diagnosis, follow-up and in analysing the completeness of treatment. Sensitive and specific detection of circulating tumour DNA (ctDNA) has potential to direct early treatment and permits monitoring of systemic dissemination.
Aim: To evaluate ctDNA as response assessment tool and as a clinico-pathological parameter.
Materials and Methods: This prospective study of 25 patients, carried out at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh India, from May 2017 to November 2018. The study evaluated ctDNA as a marker of completeness of resection after upfront surgery for OSCC. ctDNA levels were assessed in peripheral blood, before and after surgery to determine whether its quantification can be useful in evaluation of response to surgery and if circulating DNA levels correlate with clinic-pathological prognostic variables. Data analysis was done using Cox proportional model with univariate and multivariate analysis.
Results: The ctDNA levels were higher among the patient with age =40, females, short duration of disease (=3 months), infiltrative variety of tumours and lower tumour volume. The levels increase with increase in mitotic index, lymphocytic infiltrate, tumour budding and decrease with the amount of necrosis, and dysplasia but none reached statistical significance. The level of pre-operative ctDNA does not vary widely with margin status, with treatment and do not correlate with the percentage of positive nodes among the total number of nodes dissected. The cases with local recurrence or death had higher pre-operative ctDNA values (Mean pre-operative ctDNA were 294.725 and 185.6, respectively, with a p-value 0.3673).
Conclusion: The ctDNA levels are persistently elevated in OSCC and may be a measure of aggressiveness. The surgical treatment of resectable oral cavity cancers may lead to the decrease of ctDNA levels. ctDNA maybe used as a complementary method along with biopsy/histopathological findings.
Keywords
Prognosis, Resectable, Response
DOI: 10.7860/JCDR/2020/43089.13593
Date of Submission: Oct 22, 2019
Date of Peer Review: Nov 29, 2019
Date of Acceptance: Feb 22, 2020
Date of Publishing: Mar 01, 2020
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 23, 2019
• Manual Googling: Feb 12, 2020
• iThenticate Software: Feb 28, 2020 (13%)
ETYMOLOGY: Author Origin
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