液体活检可识别慢性肝病，肝癌与健康血液

StephenW

Liquid biopsy identifies chronic liver disease, liver cancer vs. healthy blood

Bhan I, et al. Gastroenterol. 2018;doi:10.1053/j.gastro.2018.09.020.
September 13, 2018

A recently developed liquid biopsy cell-sorting device was able to detect circulating epithelial cells of hepatocyte origin in blood from healthy individuals, patients with chronic liver disease without hepatocellular cancer, and those with HCC, according to a recently published study.

Irun Bhan, MD, from the Massachusetts General Hospital, and colleagues stated that hepatic circulating epithelial cells (CECs) could serve as a significant biomarker in the diagnosis and monitoring of CLD and HCC.


Bhan and colleagues developed an antigen-agnostic cell sorting device — the iChip — which isolates CECs while preserving cell viability and high-quality RNA content.

To determine the iChip’s ability to detect CECs in patients without HCC and discriminate between CECs in patients with and without HCC, the researchers obtained blood samples from 10 healthy donors, 39 patients with CLD and no evidence of HCC, 54 patients with HCC, and 10 who underwent curative treatment for HCC with no evidence of disease.

The procedure including RNA sequencing and immunofluorescent quantification with a threshold of 5 cells per 10 mL of whole blood.

CECs presented in a similar proportion of patients with CLD (79%), those with HCC (81%) and those with no evidence of HCC after treatment (90%) in contrast to 5% in the healthy donors (P < .01).

Among patients with CLD, those with advanced fibrosis (stage 3 or 4) had a higher concentration of CECs compared with those without advanced fibrosis (5.1 vs. 0.7 cells/mL; P < .01).

In a subanalysis, the researchers found that liquid biopsy CEC detection could phenotypically differentiate underlying disease state in cases of chronic liver disease vs. HCC with a preliminary sensitivity of 85% at a specificity of 95%.

“Here we report the novel detection of cells from diseased livers circulating in the bloodstream both by immunofluorescence and [RNA-sequencing] and the potential to use these cells as biomarkers. Important applications of this liquid biopsy may include CLD etiology determination, fibrosis staging, and HCC surveillance,” Bhan and colleagues wrote. “Further study of CECs could open a new field of biomarker development leading to a spectrum of non-invasive diagnosis and monitoring techniques for patients with liver disease.” – by Talitha Bennett

Disclosure: The authors report nor relevant financial disclosures.

StephenW

液体活检可识别慢性肝病，肝癌与健康血液

Bhan I，et al。 Gastroenterol。 2018; DOI：10.1053 / j.gastro.2018.09.020。
2018年9月13日

根据最近发表的一项研究，最近开发的液体活检细胞分选装置能够检测健康个体，无肝细胞癌慢性肝病患者和HCC患者血液中肝细胞来源的循环上皮细胞。

马萨诸塞州综合医院的医学博士Irun Bhan及其同事指出，肝循环上皮细胞（CECs）可作为CLD和HCC诊断和监测的重要生物标志物。


Bhan及其同事开发了一种抗原不依赖的细胞分选装置--iChip，它可以分离CEC，同时保留细胞活力和高质量的RNA含量。

为了确定iChip在没有HCC的患者中检测CEC的能力以及在有和没有HCC的患者中区分CEC，研究人员从10名健康捐献者，39名CLD患者和没有HCC证据，54名HCC患者和10名患者中获得血样。谁接受了治疗HCC而没有疾病的证据。

该程序包括RNA测序和免疫荧光定量，阈值为每10mL全血5个细胞。

CEC患者中有相似比例的CLD患者（79％），HCC患者（81％）和治疗后无HCC证据的患者（90％）与健康献血者的5％相比（P <.01） 。

在患有CLD的患者中，晚期纤维化患者（阶段3或4）与未患晚期纤维化的患者相比具有更高的CEC浓度（5.1对0.7细胞/ mL; P <.01）。

在一项亚组分析中，研究人员发现液体活检CEC检测可以在慢性肝病和HCC的病例中表型分化潜在的疾病状态，初始敏感性为85％，特异性为95％。

“在这里，我们报告了通过免疫荧光和[RNA测序]在血流中循环的患病肝脏细胞的新型检测以及使用这些细胞作为生物标志物的潜力。这种液体活检的重要应用可能包括CLD病因学测定，纤维化分期和HCC监测，“Bhan及其同事写道。 “对CEC的进一步研究可以开辟生物标志物开发的新领域，为肝病患者提供一系列非侵入性诊断和监测技术。” - 作者：Talitha Bennett

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