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Highly sensitive, non-invasive detection of colorectal cancer mutations using single molecule, third generation sequencing

机译:使用单分子第三代测序技术高度灵敏,无创地检测结直肠癌突变

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摘要

Colorectal cancer (CRC) represents one of the most prevalent and lethal malignant neoplasms and every individual of age 50 and above should undergo regular CRC screening. Currently, the most effective preventive screening procedure to detect adenomatous polyps, the precursors to CRC, is colonoscopy. Since every colorectal cancer starts as a polyp, detecting all polyps and removing them is crucial. By exactly doing that, colonoscopy reduces CRC incidence by 80%, however it is an invasive procedure that might have unpleasant and, in rare occasions, dangerous side effects. Despite numerous efforts over the past two decades, a non-invasive screening method for the general population with detection rates for adenomas and CRC similar to that of colonoscopy has not yet been established. Recent advances in next generation sequencing technologies have yet to be successfully applied to this problem, because the detection of rare mutations has been hindered by the systematic biases due to sequencing context and the base calling quality of NGS.\udWe present the first study that applies the high read accuracy and depth of single molecule, real time, circular consensus sequencing (SMRT-CCS) to the detection of mutations in stool DNA in order to provide a non-invasive, sensitive and accurate test for CRC. In stool DNA isolated from patients diagnosed with adenocarcinoma, we are able to detect mutations at frequencies below 0.5% with no false positives. This approach establishes a foundation for a non-invasive, highly sensitive assay to screen the population for CRC and the early stage adenomas that lead to CRC.
机译:大肠癌(CRC)是最普遍和致命的恶性肿瘤之一,每个50岁及以上的个人都应定期进行CRC筛查。当前,最有效的预防性筛查方法是结肠镜检查,以检测腺瘤性息肉(CRC的前体)。由于每种结肠直肠癌都是从息肉开始的,因此检测并清除所有息肉至关重要。通过这样做,结肠镜检查可将CRC发生率降低80%,但这是一种侵入性手术,可能会带来令人不愉快的副作用,在极少数情况下还会产生危险的副作用。尽管在过去的二十年中付出了许多努力,但尚未建立一种针对普通人群的无创筛查方法,其腺瘤和CRC的检出率与结肠镜检查相似。下一代测序技术的最新进展尚未成功应用于此问题,因为稀有突变的检测受到测序背景和NGS碱基检出质量的系统性偏见的阻碍。\ ud我们提出了第一项适用的研究单分子的高读取准确性和深度,实时,环形共有序列测序(SMRT-CCS)可以检测粪便DNA中的突变,从而为CRC提供非侵入性,灵敏且准确的测试。从诊断为腺癌的患者中分离出的粪便DNA中,我们能够检测到频率低于0.5%的突变而没有假阳性。这种方法为非侵入性,高度敏感的测定法奠定了基础,该方法可筛查人群中的CRC和导致CRC的早期腺瘤。

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