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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Size distribution of circulating cell-free DNA in sera of breast cancer patients in the course of adjuvant chemotherapy

Ugur Deligezer
  • 1Department of Basic Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Yesim Eralp
  • 2Department of Medical Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Ebru E. Akisik
  • 3Department of Basic Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Elif Z. Akisik
  • 4Department of Basic Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Pinar Saip
  • 5Department of Medical Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Erkan Topuz
  • 6Department of Medical Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
/ Nejat Dalay
  • 7Department of Basic Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
Published Online: 2008-02-06 | DOI: https://doi.org/10.1515/CCLM.2008.080


Background: The integrity of circulating cell-free DNA (cf-DNA) in serum or plasma appears to be of diagnostic and prognostic value in cancer. Here, we investigated the dynamics of serum DNA levels and the size distribution of cf-DNA during adjuvant chemotherapy of patients with breast cancer (n=73).

Methods: By evaluating sera taken at the beginning and the end of the adjuvant chemotherapy, variations of serum DNA levels and the size distribution were analyzed, based on quantification of shorter apoptotic and longer non-apoptotic fragments from abundant genomic ALU fragments amplified by quantitative real-time PCR.

Results: The mean DNA level did not change significantly during chemotherapy. However, individual cases revealed considerable variation in the amount of serum DNA. It increased in 43.8% of the patients, whereas it decreased in the remaining majority (56.2%). By calculating a “coefficient of variation” (both decrease and increase) in the level of total DNA and non-apoptotic DNA fragments, we compared the values at the beginning and the end of the therapy. For total DNA, the range was between 1.02- and 26-fold (mean 3.76-fold), whereas for non-apoptotic fragments it ranged from 1.01- to 73-fold (mean 6.9-fold) (p=0.033). In accordance with these findings, the integrity of serum DNA was higher in patients with increasing DNA levels and vice versa.

Conclusions: Our findings suggest that non-apoptotic fragments contribute to a higher degree to the change of the DNA level during adjuvant chemotherapy.

Clin Chem Lab Med 2008;46:311–7.

Keywords: adjuvant therapy; breast cancer; cell-free DNA; serum; size distribution

Corresponding author: Dr. Ugur Deligezer, Department of Basic Oncology, Oncology Institute, 34390 Capa/Istanbul, Turkey Phone: +90-212-4142434, Fax: +90-212-5348078,

Received: 2007-09-03

Accepted: 2007-11-20

Published Online: 2008-02-06

Published in Print: 2008-03-01

Citation Information: Clinical Chemical Laboratory Medicine. Volume 46, Issue 3, Pages 311–317, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: https://doi.org/10.1515/CCLM.2008.080, February 2008

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