Promising molecular genetic diagnostic technologies in patients with pancreatic ductal adenocarcinoma

The aim of this study was to evaluate the diagnostic and prognostic potential of QClamp™ real-time PCR technology for the detection of ctDNA carrying KRAS gene mutations in patients with pancreatic ductal adenocarcinoma.
Material and Methods. The study included 119 patients with different stages of pancreatic cancer. Cell-free DNA was isolated from blood plasma, and the most common somatic KRAS mutations were detected using XNA-mediated suppression of wild-type DNA amplifcation.
Results. KRAS mutations in plasma were identifed in 23.5 % of patients, with the detection rate of ctDNA increasing with disease progression, reaching 66.7 % in locally advanced disease and 25.0 % in metastatic pancreatic cancer. In patients with resectable stages (I–II), ctDNA was detected in only 15.6 % of cases; however, its presence was associated with signifcantly worse overall survival and recurrence-free survival. The concentration of total cell-free DNA varied substantially and did not directly correlate with disease stage, indicating the limited informative value of this parameter in the absence of molecular analysis.
Conclusion. The results obtained demonstrate that QClamp™ PCR is a rapid and technically feasible method for ctDNA detection with high specifcity. The greatest clinical applicability of this technology may lie in prognostication and monitoring of minimal residual disease after surgical treatment, complementing existing clinical and instrumental approaches.

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