Author/Authors :
Ellinger، نويسنده , , Jِrg and Bastian، نويسنده , , Patrick J. and Ellinger، نويسنده , , Nadja and Kahl، نويسنده , , Philip and Perabo، نويسنده , , Frank G. and Büttner، نويسنده , , Reinhard and Müller، نويسنده , , Stefan C. and Ruecker، نويسنده , , Alexander von، نويسنده ,
Abstract :
Patients with malignancies often possess increased concentrations of cell-free serum DNA. In this study, we investigated serum DNA levels in each 45 patients with bladder cancer (BCA) undergoing radical cystectomy and with benign prostate hyperplasia. A quantitative real-time PCR was used to amplify a 124 bp (PTGS2; mostly apoptotic origin) and a 271 bp (Reprimo; mostly necrotic origin) DNA fragment. Changes in the origin of DNA fragments were specified as the Apoptosis Index (AI, ratio of 124 bp/271 bp fragments). Small and large fragments were increased (p < 0.001 and p = 0.041) in BCA patients. The AI increase suggests that DNA fragmentation was mostly (p < 0.001) caused by apoptosis. High levels of small DNA fragments distinguished between BCA and BPH with high sensitivity (96%) and moderate specificity (62%). DNA levels and the AI were not correlated with clinicopathological parameters. However, an increased AI was correlated with BCA-specific mortality in a multivariate analysis (p = 0.011) indicating that the AI is an independent prognostic factor. Thus, cell-free DNA seems to be a useful prognostic marker in patients with BCA.
