赣南医科大学学报2026，Vol.46Issue(1)：26-31,6.DOI:10.3969/j.issn.2097-7174.2026.01.004
基于ctDNA与MRD探讨亚肺叶切除术治疗早期周围型肺腺癌的围术期疗效评估
Circulating tumor DNA and minimal residual disease for evaluating the efficacy of different sublobar resections in treating early-stage peripheral lung adenocarcinoma
摘要
Abstract
Objective:To evaluate the differences in surgical trauma and oncological efficacy between sublobar resection types for early-stage peripheral lung adenocarcinoma by monitoring plasma cell-free DNA(cfDNA),circulating tumor DNA(ctDNA),and minimal residual disease(MRD)levels.Methods:A retrospective analysis was conducted on the clinical data of 25 patients with stage IA peripheral lung adenocarcinoma who underwent sublobar surgery from January 2023 to June 2024.Among them,13 patients underwent segmentectomy(Lung_segment group)and 12 underwent wedge resection(Lung_wedge group).Tumor tissue was subjected to whole exome sequencing(WES)to screen for patient-specific high-frequency mutation sites(median 36).An individualized MRD monitoring panel was designed,and plasma ctDNA was detected using ultra-deep sequencing to evaluate MRD status.Peripheral blood samples were collected preoperatively and on postoperative day 3 to measure cfDNA concentration.Results:Among the 25 postoperative samples,ctDNA variants were detected in 3 cases,with only one variant identified in each of the positive samples.There was no statistically significant difference in the postoperative MRD-positive rate between the two groups(P>0.05).Postoperative cfDNA levels and their increment were significantly higher in the segmentectomy group than in the wedge resection group(P<0.05).Patients who developed postoperative pulmonary infections had significantly higher plasma cfDNA levels than those without infections(P<0.05).Conclusion:Segmentectomy is associated with a more significant surgical trauma response compared to wedge resection.The dynamic changes in postoperative cfDNA levels may serve as a potential biomarker for assessing tissue injury and predicting complications.关键词
肺腺癌/亚肺叶切除术/循环肿瘤DNA/微小残留病灶/血浆游离DNAKey words
Lung adenocarcinoma/Sublobar resection/Circulating tumor DNA/Minimal residual disease/Cell-free DNA分类
医药卫生引用本文复制引用
陈涛,廖国亮,唐志贤,王翠莲,钟新,钟智森,谢群燕,饶鼎宇,朱慎钰,章祖雄,古亮..基于ctDNA与MRD探讨亚肺叶切除术治疗早期周围型肺腺癌的围术期疗效评估[J].赣南医科大学学报,2026,46(1):26-31,6.基金项目
江西省卫生健康委员会科技计划青年项目(202510456) （202510456）
江西省卫生健康委员会科技计划项目(202312165) （202312165）
