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Ultra-short cell-free DNA fragments enhance cancer early detection in a multi-analyte blood test combining mutation, protein and fragmentomics

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单位: [1]Shanghai Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Med, 225 Changhai Rd, Shanghai 200438, Peoples R China [2]Zhejiang Univ, Womens Hosp, Gynecol Oncol Dept, Sch Med, 1 Xuebu Rd, Hangzhou 310006, Zhejiang, Peoples R China [3]Zhejiang Univ, Womens Hosp, Zhejiang Prov Key Lab Precis Diag & Therapy Major, Sch Med, Hangzhou, Zhejiang, Peoples R China [4]Zhejiang Prov Clin Res Ctr Obstet & Gynecol, Hangzhou, Peoples R China [5]Zhejiang Prov Key Lab Tradit Chinese Med Reprod Hl, Hangzhou, Peoples R China [6]Huazhong Univ Sci & Technol,Dept Gastrointestinal Surg,Tongji Med Coll,Tongji Hosp,Wuhan,Peoples R China [7]Second Mil Med Univ, Changhai Hosp, Dept Thorac Surg, Shanghai, Peoples R China [8]Womens Reprod Hlth Key Lab Zhejiang Prov, Hangzhou, Peoples R China [9]Accura Gen Inc, Dept Res & Dev, San Jose, CA USA [10]Yither Biotech Co Ltd, Dept Res & Dev, Shanghai, Peoples R China [11]Shanghai Yunsheng Med Lab Co Ltd, Dept Bioinformat, Shanghai, Peoples R China [12]Shanghai Yunsheng Med Lab Co Ltd, Dept Med Sci, Shanghai, Peoples R China [13]AccuraGen Inc, Dept Bioinformat, San Jose, CA USA [14]AccuraGen Inc, San Jose, CA USA [15]Shanghai Changhai Hosp, Dept Thorac Surg, Shanghai, Peoples R China [16]Naval Med Univ, Dept Gen Surg, Changzheng Hosp, Shanghai, Peoples R China [17]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Obstet & Gynaecol,Wuhan,Peoples R China
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关键词: cell-free DNA circulating tumor DNA fragmentomics multi-cancer early detection single-strand DNA sequencing ultra-short fragments

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Objectives: Cancer morbidity and mortality can be reduced if the cancer is detected early. Cell-free DNA (cfDNA) fragmentomics emerged as a novel epigenetic biomarker for early cancer detection, however, it is still at its infancy and requires technical improvement. We sought to apply a single-strand DNA sequencing technology, for measuring genetic and fragmentomic features of cfDNA and evaluate the performance in detecting multiple cancers.Methods: Blood samples of 364 patients from six cancer types (colorectal, esophageal, gastric, liver, lung, and ovarian cancers) and 675 healthy individuals were included in this study. Circulating tumor DNA mutations, cfDNA fragmentomic features and a set of protein biomarkers were assayed. Sensitivity and specificity were reported by cancer types and stages.Results: Circular Ligation Amplification and sequencing (CLAmp-seq), a single-strand DNA sequencing technology, yielded a population of ultra-short fragments (<100 bp) than double-strand DNA preparation protocols and reveals a more significant size difference between cancer and healthy cfDNA fragments (25.84 bp vs. 16.05 bp). Analysis of the subnucleosomal peaks in ultra-short cfDNA fragments indicates that these peaks are regulatory element "footprints" and correlates with gene expression and cancer stages. At 98 % specificity, a prediction model using ctDNA mutations alone showed an overall sensitivity of 46 %; sensitivity reaches 60 % when protein is added, sensitivity further increases to 66 % when fragmentomics is also integrated. More improvements observed for samples representing earlier cancer stages than later ones.Conclusions: These results suggest synergistic properties of protein, genetic and fragmentomics features in the identification of early-stage cancers.

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 医学实验技术
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大类 | 2 区 医学
小类 | 2 区 医学实验技术
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Q1 MEDICAL LABORATORY TECHNOLOGY
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Q1 MEDICAL LABORATORY TECHNOLOGY

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第一作者单位: [2]Zhejiang Univ, Womens Hosp, Gynecol Oncol Dept, Sch Med, 1 Xuebu Rd, Hangzhou 310006, Zhejiang, Peoples R China [3]Zhejiang Univ, Womens Hosp, Zhejiang Prov Key Lab Precis Diag & Therapy Major, Sch Med, Hangzhou, Zhejiang, Peoples R China [4]Zhejiang Prov Clin Res Ctr Obstet & Gynecol, Hangzhou, Peoples R China
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通讯机构: [2]Zhejiang Univ, Womens Hosp, Gynecol Oncol Dept, Sch Med, 1 Xuebu Rd, Hangzhou 310006, Zhejiang, Peoples R China [3]Zhejiang Univ, Womens Hosp, Zhejiang Prov Key Lab Precis Diag & Therapy Major, Sch Med, Hangzhou, Zhejiang, Peoples R China [4]Zhejiang Prov Clin Res Ctr Obstet & Gynecol, Hangzhou, Peoples R China [5]Zhejiang Prov Key Lab Tradit Chinese Med Reprod Hl, Hangzhou, Peoples R China
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