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Korean Journal of Clinical Oncology > Article
Korean J Clin Oncol. 2021;17(2): 59-67.         doi: https://doi.org/10.14216/kjco.21010
Clinical relevance and prognostic role of preoperative cell-free single-stranded DNA concentrations in colorectal cancer patients
Hyun Soo Song1 , Dong Hyun Kang1 , Hyunjung Kim1, Tae Sung Ahn1 , Tae Wan Kim2, Moo-Jun Baek1
1Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
2Department of Medical Life Science, Soonchunhyang University, Asan, Korea
Corresponding Author: Moo-Jun Baek ,Tel: +82-41-570-3633, Fax: +82-41-571-0129, Email: ssurge@schmc.ac.kr
Received: September 9, 2021;  Accepted: November 19, 2021.
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Purpose: Circulating cell-free single-stranded DNA (ccf-ssDNA) is extracellular DNA and it is a useful biomarker for the diagnosis of tumors and predicting the prognosis of tumors. However, the clinical usefulness of ccf-ssDNA in colorectal cancer (CRC) is not well known. Thus, the purpose of this study was to investigate the clinical usefulness of ccf-ssDNA in CRC.
Methods: The study was conducted on 44 patients who had undergone surgery for CRC, and ccf-ssDNA level was measured before surgery and statistical analysis was performed on clinical factors.
Results: The association between ccf-ssDNA level and clinicopathological factors was analyzed and compared, and these factors included age, sex, body mass index, diabetes mellitus, hypertension, tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), tumor location, size, stage (TNM), recurrence, and death. The group with a ccf-ssDNA level of ≥ 7.5 ng/μL had a lower age (P = 0.010), and was associated with diabetes mellitus (P = 0.037) and lymph node metastasis (P = 0.049). Multivariate analysis of disease-free survival showed that lymph node metastasis and ccf-ssDNA level (hazard ratio, 10.011; 95% confidence interval, 2.269–44.175; P = 0.002) were independent prognostic factors for recurrence. In terms of overall survival, there were no statistically significant results except for vascular invasion.
Conclusion: This study showed that ccf-ssDNA level in plasma in CRC patients was an independent prognostic factor that could predict recurrence non-invasively. In this regard, further evaluation with a prospective, large sample size study will be needed to obtain additional results.
Keywords: Colon cancer | Colorectal cancer recurrence | Circulating cell-free single-stranded DNA | Circulating cell-free DNA | Liquid biopsy
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