Gastrointestinal Tract - Original Article

Vol. 32 No. 9 (2021): Turkish Journal of Gastroenterology

Fragmentation Analysis of Plasma DNA Reveals Its Prognostic Value in Gastric Cancer

Main Article Content

Ebru Esin Yoruker
Emre Ozgur
Metin Keskin
Ilker Ozgur
Ugur Gezer

Abstract

Background: Gastric cancer (GC) is a common cause of cancer-related deaths. The poor clinical outcome in GC patients is partially

associated with a lack of appropriate diagnostic and prognostic biomarkers. In the present study, we evaluated the diagnostic and

prognostic values of cell-free DNA (cfDNA) integrity and the concentration of circulating nucleosomes (cNUCs).

Methods: In the study, 40 GC patients and 55 GC-free individuals were enrolled. Cell-free DNA integrity was calculated as the ratio of

concentration of the longer ACTB (beta-actin) gene fragment to that of the shorter ACTB fragment, measured using quantitative PCR.

Circulating nucleosomes were measured by an ELISA-based approach.

Results: We found that cfDNA integrity is higher in GC patients than in the control subjects (relative median values 0.51 vs. 0.38, respectively,

P = .56) indicating prominent abundance of longer fragments in the patients. The patients with larger tumors (T3-4) had significantly

higher cfDNA integrity than those with T1-T2 tumors. We also found GC patients to have higher concentrations of cNUCs in their

plasma (relative median values 3.64 vs. 3.1). Importantly, the patients with high cfDNA integrity (i.e., lower fragmentation) had longer

overall survival rates at 3 years than those with lower cfDNA integrity (76.5% vs. 38.9%, P = .02).

Conclusion: Cell-free DNA fragmentation has a prognostic value. However, it has no diagnostic value in GC.

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