Introduction/Background To investigate whether preoperative peritoneal irrigation fluid or ascites circulating tumor DNA (ctDNA) detection in ovarian cancer patients can be used as a substitute or supplement for tumor tissue when it is not desirable; Whether preoperative peritoneal irrigation fluid or ascites ctDNA testing is more sensitive than cytology and can be used to aid diagnosis of metastasis and clinical staging.
Methodology A total of 24 patients with stage I-IV ovarian cancer who underwent surgery in the Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital from November 1, 2021 to August 31, 2022 were enrolled. Preoperative peritoneal irrigation fluid or ascites and blood and tumor tissue samples were taken. The patient‘s tumor tissue, blood and peritoneal irrigation fluid or ascites were sequenced by gene chip target area capture and high-throughput sequencing detection technology, and 520 genes highly related to tumor development and personalized treatment were sequenced, and the consistency of circulating tumor DNA detection rate in peritoneal fluid with genetic mutations in tissue samples was evaluated, whether peritoneal irrigation fluid or ascites next-generation sequencing (NGS) was more sensitive than blood NGS, and the consistency of peritoneal irrigation fluid.
Results A total of 24 patients with ovarian cancer were screened according to the inclusion exclusion criteria, and a total of 70 samples (including 24 tissue samples, 24 blood samples, 22 peritoneal irrigation fluid or ascites samples) from 24 patients were included in the follow-up analysis. The mutation detection rate was 100% (24/24) in tumor tissue samples, 82% in abdominal irrigation fluid or ascites samples, and 62% in blood samples.
Conclusion The detection of ctDNA in peritoneal washing fluid or ascitic fluid can be used as a priority replacement or supplement when tumor tissue is not desirable, and can also be used for auxiliary diagnosis of metastasis and clinical staging.
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