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Circulating tumor DNA as a predictive marker for occult metastases in pancreatic cancer patients with radiographically non‐metastatic disease
Author(s) -
Hata Tatsuo,
Mizuma Masamichi,
Iseki Masahiro,
Takadate Tatsuyuki,
Ishida Masaharu,
Nakagawa Kei,
Hayashi Hiroki,
Morikawa Takanori,
Motoi Fuyuhiko,
Unno Michiaki
Publication year - 2021
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.993
Subject(s) - occult , medicine , pancreatic cancer , oncology , hazard ratio , cancer , odds ratio , gastroenterology , pathology , confidence interval , alternative medicine
Purpose To elucidate the effectiveness of circulating tumor DNA (ctDNA) for predicting occult metastases in patients with pancreatic cancer without apparent metastases. Methods Circulating tumor DNA was obtained from plasma samples of 165 patients with pancreatic cancer and analyzed using droplet digital PCR. The prevalence and allele frequencies of ctDNA were compared across different patterns and degrees of metastatic spread. Results Of the 142 patients without apparent metastases who underwent abdominal exploration, 39 (27.5%) harbored occult metastases including positive peritoneal lavage cytology. The prevalence of ctDNA was significantly higher in patients with occult metastases than in those without (41.0% vs 14.6%, P = .001). A markedly high prevalence of ctDNA was observed in patients with radiographically visible metastases (78.3%). ctDNA was found to be an independent predictor of the presence of occult metastases (odds ratio: 3.113, P = .039), and its diagnostic performance in combination with tumor markers had a sensitivity of 66.7% and a specificity of 81.6%. In 62 treatment‐naïve patients without metastases, multivariate analysis identified the presence of ctDNA as an independent prognostic factor (hazard ratio: 6.311, P = .001). Conclusion Circulating tumor DNA can help predict the presence of occult metastases in pancreatic cancer patients with radiographically non‐metastatic disease.