{"id":13770,"date":"2025-10-26T15:52:03","date_gmt":"2025-10-26T08:22:03","guid":{"rendered":"https:\/\/abtvn.com\/?p=13770"},"modified":"2025-12-29T12:26:35","modified_gmt":"2025-12-29T04:56:35","slug":"ky-thuat-ddpcr-ung-dung-trong-ung-thu-phoi-khong-te-bao-nho","status":"publish","type":"post","link":"https:\/\/abtvn.com\/en\/ky-thuat-ddpcr-ung-dung-trong-ung-thu-phoi-khong-te-bao-nho\/","title":{"rendered":"Droplet Digital PCR (ddPCR): \u1ee8ng d\u1ee5ng trong ph\u00e1t hi\u1ec7n v\u00e0 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf<\/strong>"},"content":{"rendered":"

\u1ede b\u00e0i vi\u1ebft tr\u01b0\u1edbc, ch\u00fang ta \u0111\u00e3 t\u00ecm hi\u1ec3u t\u1ed5ng quan v\u1ec1 PCR k\u1ef9 thu\u1eadt s\u1ed1 dPCR<\/strong><\/a> v\u00e0 h\u01b0\u1edbng d\u1eabn th\u1ef1c hi\u1ec7n tr\u00ean hai h\u1ec7 th\u1ed1ng ph\u1ed5 bi\u1ebfn l\u00e0 Bioer (cdPCR) v\u00e0 Bio-Rad (ddPCR). B\u00e0i vi\u1ebft n\u00e0y s\u1ebd \u0111i s\u00e2u v\u00e0o t\u00ecm hi\u1ec3u \u1ee9ng d\u1ee5ng PCR k\u1ef9 thu\u1eadt s\u1ed1 vi gi\u1ecdt (Droplet Digital PCR hay ddPCR) nh\u01b0 m\u1ed9t c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7y ti\u1ec1m n\u0103ng cho b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (non-small cell lung cancer).<\/p>\n\n\n\n

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1. Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC) l\u00e0 g\u00ec?<\/strong><\/h2>\n\n\n\n

Ung th\u01b0 ph\u1ed5i l\u00e0 lo\u1ea1i ung th\u01b0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n nhi\u1ec1u th\u1ee9 hai tr\u00ean th\u1ebf gi\u1edbi, ch\u1ec9 sau ung th\u01b0 v\u00fa. T\u1ea1i Vi\u1ec7t Nam, ung th\u01b0 ph\u1ed5i n\u1eb1m trong nh\u00f3m ba lo\u1ea1i ung th\u01b0 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t (GLOBOCAN, 2022), t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t \u1edf giai \u0111o\u1ea1n cu\u1ed1i th\u01b0\u1eddng th\u1ea5p. D\u1ef1a tr\u00ean h\u00ecnh th\u00e1i t\u1ebf b\u00e0o v\u00e0 mi\u1ec5n d\u1ecbch h\u1ecdc, ung th\u01b0 ph\u1ed5i \u0111\u01b0\u1ee3c chia th\u00e0nh ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf (10-15%) v\u00e0 ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC) (H\u00ecnh 1).<\/p>\n\n\n\n

Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC) l\u00e0 lo\u1ea1i ung th\u01b0 ph\u1ed5 bi\u1ebfn nh\u1ea5t, chi\u1ebfm kho\u1ea3ng 85-90% c\u00e1c tr\u01b0\u1eddng h\u1ee3p. \u0110\u00e2y l\u00e0 m\u1ed9t nh\u00f3m c\u00e1c lo\u1ea1i ung th\u01b0 ph\u1ed5i c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m t\u1ebf b\u00e0o l\u1edbn h\u01a1n v\u00e0 ph\u00e1t tri\u1ec3n ch\u1eadm h\u01a1n so v\u1edbi ung th\u01b0 ph\u1ed5i t\u1ebf b\u00e0o nh\u1ecf. NSCLC \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i th\u00e0nh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o tuy\u1ebfn (40% c\u1ee7a NSCLC), ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o l\u1edbn (10-15% c\u1ee7a NSCLC), ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o v\u1ea3y (25-30% c\u1ee7a NSCLC) v\u00e0 kh\u1ed1i u carcinoid ph\u1ebf qu\u1ea3n.<\/p>\n\n\n\n

\"H\u00ecnh
Figure 1<\/strong> Ph\u00e2n lo\u1ea1i ung th\u01b0 ph\u1ed5i<\/em><\/figcaption><\/figure>\n\n\n\n

Nguy\u00ean nh\u00e2n g\u00e2y ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh do nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1. \u01af\u1edbc t\u00ednh 80-90% ung th\u01b0 ph\u1ed5i li\u00ean quan \u0111\u1ebfn thu\u1ed1c l\u00e1. M\u1ed9t ng\u01b0\u1eddi h\u00fat m\u1ed9t g\u00f3i thu\u1ed1c m\u1ed7i ng\u00e0y c\u00f3 nguy c\u01a1 m\u1eafc ung th\u01b0 ph\u1ed5i g\u1ea5p 20 l\u1ea7n ng\u01b0\u1eddi kh\u00f4ng h\u00fat thu\u1ed1c. Ng\u01b0\u1eddi s\u1ed1ng c\u00f9ng nh\u00e0 v\u1edbi ng\u01b0\u1eddi h\u00fat thu\u1ed1c t\u0103ng 30% nguy c\u01a1 ung th\u01b0 ph\u1ed5i so v\u1edbi ng\u01b0\u1eddi kh\u00f4ng c\u00f9ng ho\u00e0n c\u1ea3nh. M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c do ti\u1ebfp x\u00fac amian, b\u1ee5i ph\u00f3ng x\u1ea1 v\u00e0 radon, nhi\u1ec5m khu\u1ea9n, \u00f4 nhi\u1ec5m kh\u00f4ng kh\u00ed v\u00e0 c\u00e1c b\u1ec7nh di truy\u1ec1n.<\/p>\n\n\n\n

Theo h\u01b0\u1edbng d\u1eabn c\u1ee7a M\u1ea1ng l\u01b0\u1edbi Ung th\u01b0 To\u00e0n di\u1ec7n Qu\u1ed1c gia Hoa K\u1ef3 (National Comprehensive Cancer Network), c\u00e1c \u0111\u1ed9t bi\u1ebfn ho\u1eb7c bi\u1ebfn \u0111\u1ed5i gene trong NSCLC th\u01b0\u1eddng kh\u00f4ng tr\u00f9ng l\u1eb7p, nh\u01b0ng 1\u20133% tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 mang \u0111\u1ed3ng th\u1eddi nhi\u1ec1u \u0111\u1ed9t bi\u1ebfn. C\u00e1c \u0111\u1ed9t bi\u1ebfn ch\u1ee7 y\u1ebfu bao g\u1ed3m EGFR, EGFR p.T790M, EGFRex20, ALK, ROS1, BRAF, KRAS, MET, RET, ERBB2, HER2, NTRK1\/2\/3, PD-L1<\/em>. Trong \u0111\u00f3, \u0111\u1ed9t bi\u1ebfn gene chi\u1ebfm t\u1ef7 l\u1ec7 cao l\u00e0 EGFR<\/em> (35.4%) v\u00e0 KRAS<\/em> (22.6%). Nhi\u1ec1u \u0111\u1ed9t bi\u1ebfn gene \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb, do \u0111\u00f3 c\u1ea7n x\u00e9t nghi\u1ec7m c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc t\u1eeb m\u00f4 ho\u1eb7c m\u00e1u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh li\u1ec7u ph\u00e1p nh\u1eafm tr\u00fang \u0111\u00edch ph\u00f9 h\u1ee3p, tr\u00e1nh c\u00e1c ph\u01b0\u01a1ng ph\u00e1p k\u00e9m hi\u1ec7u qu\u1ea3. N\u0103m 2021, C\u1ee5c Qu\u1ea3n l\u00fd Th\u1ef1c ph\u1ea9m v\u00e0 D\u01b0\u1ee3c ph\u1ea9m Hoa K\u1ef3 FDA \u0111\u00e3 ch\u1ea5p thu\u1eadn sotorasib v\u00e0 amivantamab \u0111i\u1ec1u tr\u1ecb c\u00e1c kh\u1ed1i u ch\u1ee9a KRAS<\/em> G12C v\u00e0 \u0111\u1ed9t bi\u1ebfn ch\u00e8n th\u00eam \u0111o\u1ea1n 20 exon  v\u00e0o gene EGFR<\/em>. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc khi \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf EGFR<\/em> c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c l\u00e0m x\u00e9t nghi\u1ec7m t\u00ecnh tr\u1ea1ng gene.<\/p>\n\n\n\n

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2. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n ph\u00e2n t\u1eed ph\u00e1t hi\u1ec7n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC)<\/strong><\/strong><\/h2>\n\n\n\n

T\u1ef7 l\u1ec7 t\u1eed vong do ung th\u01b0 ph\u1ed5i cao do b\u1ec7nh th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0o giai \u0111o\u1ea1n ti\u1ebfn xa n\u00ean c\u1ea7n t\u0103ng c\u01b0\u1eddng hi\u1ec7u qu\u1ea3 ho\u1ea1t \u0111\u1ed9ng t\u1ea7m so\u00e1t, ph\u00e1t hi\u1ec7n s\u1edbm ung th\u01b0 ph\u1ed5i. M\u1ed7i ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n b\u1ec7nh \u0111\u1ec1u c\u00f3 \u01b0u v\u00e0 nh\u01b0\u1ee3c \u0111i\u1ec3m ri\u00eang, \u0111\u00f2i h\u1ecfi b\u00e1c s\u0129 l\u00e2m s\u00e0ng ph\u1ea3i c\u00e2n nh\u1eafc k\u1ef9 tr\u01b0\u1edbc khi l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p nh\u1eb1m ti\u1ebft ki\u1ec7m th\u1eddi gian, chi ph\u00ed x\u00e9t nghi\u1ec7m v\u00e0 gi\u1ea3m b\u1edbt kh\u00f3 ch\u1ecbu cho b\u1ec7nh nh\u00e2n.<\/p>\n\n\n\n

Ph\u01b0\u01a1ng ph\u00e1p Real-time PCR<\/a><\/strong> \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u1ed9t bi\u1ebfn EGFR<\/em> nh\u1eafm m\u1ee5c ti\u00eau v\u00e0o \u0111\u1ed9t bi\u1ebfn c\u1ee5 th\u1ec3. Gi\u1ea3i tr\u00ecnh t\u1ef1 th\u1ebf h\u1ec7 m\u1edbi NGS gi\u00fap x\u00e1c \u0111\u1ecbnh to\u00e0n di\u1ec7n c\u00e1c bi\u1ebfn \u0111\u1ed5i gene. Ph\u01b0\u01a1ng ph\u00e1p lai hu\u1ef3nh quang t\u1ea1i ch\u1ed7 (FISH)<\/strong> \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e2n t\u00edch s\u1ed1 l\u01b0\u1ee3ng b\u1ea3n sao, khu\u1ebfch \u0111\u1ea1i gene v\u00e0 c\u00e1c thay \u0111\u1ed5i v\u1ec1 c\u1ea5u tr\u00fac nh\u01b0 s\u1eafp x\u1ebfp l\u1ea1i gene. Tuy nhi\u00ean, m\u1ed7i ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ec1u c\u00f3 h\u1ea1n ch\u1ebf. V\u00ed d\u1ee5, IHC ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o thao t\u00e1c k\u1ef9 thu\u1eadt vi\u00ean; FISH y\u00eau c\u1ea7u m\u1eabu FFPE ch\u1ea5t l\u01b0\u1ee3ng cao; c\u00f2n NGS v\u00e0 MLPA c\u00f3 quy tr\u00ecnh ph\u1ee9c t\u1ea1p, c\u1ea7n nh\u00e2n s\u1ef1 chuy\u00ean m\u00f4n cao v\u00e0 chi ph\u00ed l\u1edbn<\/p>\n\n\n\n

G\u1ea7n \u0111\u00e2y, PCR k\u1ef9 thu\u1eadt s\u1ed1 vi gi\u1ecdt (ddPCR)<\/strong> <\/a>\u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n v\u00e0 \u1ee9ng d\u1ee5ng r\u1ed9ng r\u00e3i trong ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn soma c\u0169ng nh\u01b0 \u0111\u1ecbnh l\u01b0\u1ee3ng ch\u00ednh x\u00e1c nucleic acid m\u1ee5c ti\u00eau c\u00f3 trong m\u1eabu. M\u1ed9t trong nh\u1eefng \u1ee9ng d\u1ee5ng quan tr\u1ecdng c\u1ee7a ddPCR l\u00e0 kh\u1ea3 n\u0103ng \u0111\u1ecbnh l\u01b0\u1ee3ng nucleic acid tuy\u1ec7t \u0111\u1ed1i m\u00e0 kh\u00f4ng c\u1ea7n s\u1eed d\u1ee5ng c\u00e1c \u0111\u1ed1i ch\u1ee9ng n\u1ed9i sinh<\/a>. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c cao cho ph\u00e9p ph\u00e1t hi\u1ec7n m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf DNA \u0111\u1ed9t bi\u1ebfn, v\u1edbi t\u1ea7n s\u1ed1 alen trong kho\u1ea3ng t\u1eeb 0,001\u20130,4%. Nh\u1edd \u0111\u1ed9 nh\u1ea1y v\u01b0\u1ee3t tr\u1ed9i, ddPCR tr\u1edf th\u00e0nh c\u00f4ng c\u1ee5 h\u1eefu \u00edch \u0111\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn hi\u1ebfm c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb c\u00e1c t\u1ebf b\u00e0o kh\u1ed1i u trong m\u1ed9t n\u1ec1n m\u1eabu ph\u1ee9c t\u1ea1p.<\/p>\n\n\n\n

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3. \u1ee8ng d\u1ee5ng ddPCR trong nghi\u00ean c\u1ee9u \u0111\u1ed9t bi\u1ebfn EGFR<\/em> \u1edf huy\u1ebft t\u01b0\u01a1ng c\u1ee7a b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC)<\/strong><\/strong><\/strong><\/h2>\n\n\n\n

Trong ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf, th\u1ee5 th\u1ec3 y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng bi\u1ec3u b\u00ec (EGFR<\/em>) l\u00e0 m\u1ed9t glycoprotein xuy\u00ean m\u00e0ng bi\u1ec3u hi\u1ec7n m\u1ee9c \u0111\u1ed9 cao \u1edf c\u00e1c kh\u1ed1i u ph\u1ed5i. C\u00e1c \u0111\u1ed9t bi\u1ebfn EGFR<\/em> ph\u1ed5 bi\u1ebfn nh\u1ea5t n\u1eb1m \u1edf v\u00f9ng tyrosine kinase c\u1ee7a gene EGFR. <\/em>Khi gene EGFR <\/em>b\u1ecb \u0111\u1ed9t bi\u1ebfn, t\u1ebf b\u00e0o c\u00f3 th\u1ec3 t\u0103ng sinh m\u1ea5t ki\u1ec3m so\u00e1t d\u1eabn \u0111\u1ebfn ung th\u01b0. Do \u0111\u00f3, vi\u1ec7c ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn EGFR<\/em> \u0111\u00e3 tr\u1edf th\u00e0nh \u0111\u00edch nh\u1eafm cho li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u00edch, nh\u01b0 thu\u1ed1c \u1ee9c ch\u1ebf tyrosine kinase (TKIs) \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 NSCLC.<\/p>\n\n\n\n

\u1ee8ng d\u1ee5ng k\u1ef9 thu\u1eadt ddPCR, nh\u00f3m t\u00e1c gi\u1ea3 Lynn Yim-Wah Shong v\u00e0 c\u1ed9ng s\u1ef1 (2024) \u0111\u00e3 ti\u1ebfn h\u00e0nh x\u00e9t nghi\u1ec7m DNA huy\u1ebft t\u01b0\u01a1ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn EGFR<\/em> trong tr\u01b0\u1eddng h\u1ee3p m\u1eabu m\u00f4 kh\u1ed1i u kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 ph\u00e2n t\u00edch. ctDNA (circulating tumor DNA)<\/a> <\/strong>c\u00f2n g\u1ecdi l\u00e0 c\u00e1c \u0111o\u1ea1n DNA \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng t\u1eeb kh\u1ed1i u v\u00e0o m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n ung th\u01b0. ctDNA mang \u0111\u1eb7c \u0111i\u1ec3m di truy\u1ec1n \u0111\u1eb7c tr\u01b0ng c\u1ee7a kh\u1ed1i u, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t c\u00f4ng c\u1ee5 ch\u1ea9n \u0111o\u00e1n ph\u00e2n t\u1eed kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 theo d\u00f5i ti\u1ebfn tri\u1ec3n kh\u1ed1i u theo th\u1eddi gian th\u1ef1c. V\u00ec v\u1eady, ctDNA trong huy\u1ebft t\u01b0\u01a1ng l\u00e0 m\u1ee5c ti\u00eau ph\u00e2n t\u00edch ki\u1ec3u gene \u0111\u1ec3 t\u00ecm \u0111\u1ed9t bi\u1ebfn EGFR<\/em> b\u1eb1ng h\u1ec7 th\u1ed1ng PCR k\u1ef9 thu\u1eadt s\u1ed1 d\u1ea1ng gi\u1ecdt QX200 (Bio-Rad) theo quy tr\u00ecnh \u0111\u00e3 tr\u00ecnh b\u00e0y \u1edf b\u00e0i vi\u1ebft tr\u01b0\u1edbc. \u0110\u1ed3ng th\u1eddi, c\u00e1c m\u1eabu sinh thi\u1ebft m\u00f4 c\u0169ng \u0111\u01b0\u1ee3c ph\u00e2n t\u00edch real-time PCR nh\u1eb1m \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng \u0111\u1ed9t bi\u1ebfn EGFR (H\u00ecnh<\/em> 2)<\/p>\n\n\n\n

\"H\u00ecnh
Figure 2: <\/strong>Quy tr\u00ecnh nghi\u00ean c\u1ee9u c\u1ee7a nh\u00f3m t\u00e1c gi\u1ea3 Lynn Yim-Wah Shong v\u00e0 c\u1ed9ng s\u1ef1 (2024)<\/em><\/figcaption><\/figure>\n\n\n\n

Trong s\u1ed1 c\u00e1c b\u1ec7nh nh\u00e2n m\u1edbi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc ung th\u01b0 ph\u1ed5i, c\u00e1c \u0111\u1ed9t bi\u1ebfn EGFR<\/em> ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh trong m\u1eabu huy\u1ebft t\u01b0\u01a1ng l\u00e0 L858R tr\u00ean exon 21 v\u00e0 \u0111\u1ed9t bi\u1ebfn x\u00f3a \u0111o\u1ea1n exon 19. \u0110\u1ed9t bi\u1ebfn EGFR<\/em> hi\u1ebfm g\u1eb7p \u1edf giai \u0111o\u1ea1n s\u1edbm (I v\u00e0 II) nh\u01b0ng t\u1ef7 l\u1ec7 ph\u00e1t hi\u1ec7n cao h\u01a1n \u0111\u00e1ng k\u1ec3 \u1edf ung th\u01b0 ph\u1ed5i giai \u0111o\u1ea1n IV, nh\u1eefng ph\u00e1t hi\u1ec7n t\u01b0\u01a1ng t\u1ef1 c\u0169ng \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nghi ng\u1edd ung th\u01b0 ph\u1ed5i ph\u1ea3n \u00e1nh m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa l\u01b0\u1ee3ng ctDNA huy\u1ebft t\u01b0\u01a1ng v\u00e0 m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n b\u1ec7nh.<\/p>\n\n\n\n

\"\"
H\u00ecnh 3: <\/strong>Ph\u00e2n t\u00edch ki\u1ec3u gene EGFR huy\u1ebft t\u01b0\u01a1ng v\u00e0 t\u1ef7 l\u1ec7 \u0111\u1ed9t bi\u1ebfn theo giai \u0111o\u1ea1n ung th\u01b0 ph\u1ed5i.<\/em><\/figcaption><\/figure>\n\n\n\n

X\u00e9t nghi\u1ec7m \u0111\u1ed9t bi\u1ebfn EGFR<\/em> trong huy\u1ebft t\u01b0\u01a1ng b\u1eb1ng ddPCR l\u00e0 ph\u01b0\u01a1ng ph\u00e1p kh\u00f4ng x\u00e2m l\u1ea5n gi\u00fap ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn EGFR<\/em> \u1edf b\u1ec7nh nh\u00e2n nghi ng\u1edd ung th\u01b0 ph\u1ed5i ti\u1ebfn tri\u1ec3n, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi kh\u1ed1i u kh\u00f3 ti\u1ebfp c\u1eadn ho\u1eb7c kh\u1ea3 n\u0103ng kh\u00f4ng thu \u0111\u01b0\u1ee3c m\u1eabu m\u00f4 ch\u1ea5t l\u01b0\u1ee3ng cao. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y s\u1eed d\u1ee5ng m\u1eabu m\u00e1u ho\u1eb7c huy\u1ebft t\u01b0\u01a1ng cho ph\u00e9p ch\u1ea9n \u0111o\u00e1n hi\u1ec7u qu\u1ea3 c\u00e1c \u0111\u1ed9t bi\u1ebfn EGFR<\/em>, g\u00f3p ph\u1ea7n h\u1ed7 tr\u1ee3 ch\u1ea9n \u0111o\u00e1n v\u00e0 c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh.<\/p>\n\n\n\n

Tuy nhi\u00ean, c\u0169ng c\u1ea7n l\u01b0u \u00fd \u0111\u1ed9 nh\u1ea1y c\u1ee7a ddPCR c\u00f2n h\u1ea1n ch\u1ebf trong vi\u1ec7c ph\u00e1t hi\u1ec7n \u0111\u1ed9t bi\u1ebfn EGFR<\/em> \u1edf giai \u0111o\u1ea1n \u0111\u1ea7u. V\u00ec v\u1eady, c\u1ea7n ph\u1ea3i nghi\u00ean c\u1ee9u c\u1ea3i thi\u1ec7n ho\u1eb7c c\u00f3 c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n k\u1ebft h\u1ee3p \u0111\u1ec3 n\u00e2ng cao \u0111\u1ed9 ch\u00ednh x\u00e1c ph\u00e1t hi\u1ec7n \u1edf giai \u0111o\u1ea1n \u0111\u1ea7u nh\u1eb1m \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng ch\u00ednh x\u00e1c cho b\u1ec7nh nh\u00e2n.<\/a><\/p>\n\n\n\n

<\/div>\n\n\n\n

4. Ti\u1ec1m n\u0103ng \u1ee9ng d\u1ee5ng ddPCR trong x\u00e9t nghi\u1ec7m ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (NSCLC) t\u1ea1i Vi\u1ec7t Nam<\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n

Theo quy\u1ebft \u0111\u1ecbnh S\u1ed1 4825\/Q\u0110-BYT ban h\u00e0nh t\u00e0i li\u1ec7u chuy\u00ean m\u00f4n \u201ch\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf\u201d, PCR k\u1ef9 thu\u1eadt s\u1ed1 l\u00e0 m\u1ed9t trong c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u00e9t nghi\u1ec7m sinh h\u1ecdc ph\u00e2n t\u1eed \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t s\u1eed d\u1ee5ng cho x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n \u0111\u1ed9t bi\u1ebfn gene EGFR<\/em>. \u0110i\u1ec3n h\u00ecnh trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p m\u1eabu m\u00f4 b\u1ec7nh h\u1ecdc hay t\u1ebf b\u00e0o h\u1ecdc kh\u00f4ng \u0111\u1ee7 s\u1ed1 l\u01b0\u1ee3ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n sinh h\u1ecdc ph\u00e2n t\u1eed, c\u00f3 th\u1ec3 d\u00f9ng m\u1eabu huy\u1ebft t\u01b0\u01a1ng \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c \u0111\u1ed9t bi\u1ebfn EGFR<\/em> m\u1eafc ph\u1ea3i hay th\u1ee9 ph\u00e1t sau khi \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00e1c thu\u1ed1c kh\u00e1ng tyrosine kinase (TKIs).<\/p>\n\n\n\n

\"\"
Figure 4. <\/strong>S\u01a1 \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf theo quy\u1ebft \u0111\u1ecbnh S\u1ed1 4825\/Q\u0110-BYT<\/em><\/figcaption><\/figure>\n\n\n\n

Ngo\u00e0i ra, m\u1ed9t s\u1ed1 b\u1ec7nh vi\u1ec7n t\u1ea1i Vi\u1ec7t Nam \u0111\u00e3 \u1ee9ng d\u1ee5ng ddPCR trong x\u00e9t nghi\u1ec7m c\u00e1c \u0111\u1ed9t bi\u1ebfn gene kh\u00e1c li\u00ean quan \u0111\u1ebfn nguy c\u01a1 ung th\u01b0, nh\u01b0 \u0111\u1ed9t bi\u1ebfn gene BCR-ABL<\/em>. Sau khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c \u0111\u00edch, s\u1ebd ti\u1ebfp t\u1ee5c l\u00e0m x\u00e9t nghi\u1ec7m \u0111\u1ec3 theo d\u00f5i qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb gi\u00fap \u0111\u00e1nh gi\u00e1 s\u1ed1 l\u01b0\u1ee3ng b\u1ea3n sao c\u1ee7a gene g\u00e2y b\u1ec7nh trong m\u00e1u. T\u1eeb \u0111\u00f3, \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng lui b\u1ec7nh \u1edf m\u1ee9c \u0111\u1ed9 ph\u00e2n t\u1eed, gi\u00fap b\u00e1c s\u0129 l\u00e2m s\u00e0ng \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh ng\u01b0ng thu\u1ed1c cho ng\u01b0\u1eddi b\u1ec7nh \u1edf th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p ho\u1eb7c theo d\u00f5i, \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ea3 qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u00f3 th\u1ec3 ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i ph\u00e1t c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh theo th\u1eddi gian, t\u1eeb \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0a ra c\u00e1c ph\u00e1c \u0111\u1ed3 v\u00e0 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n\n\n\n

Nh\u01b0 v\u1eady, h\u01b0\u1edbng \u1ee9ng d\u1ee5ng ddPCR v\u00e0o x\u00e9t nghi\u1ec7m d\u1ea5u \u1ea5n sinh h\u1ecdc ph\u00e2n t\u1eed l\u00e0 m\u1ed9t xu th\u1ebf ph\u00e1t tri\u1ec3n \u0111\u1ea7y ti\u1ec1m n\u0103ng trong t\u01b0\u01a1ng lai. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y kh\u00f4ng ch\u1ec9 l\u00e0m gi\u1ea3m b\u1edbt s\u1ef1 kh\u00f3 ch\u1ecbu cho b\u1ec7nh nh\u00e2n trong qu\u00e1 tr\u00ecnh l\u1ea5y m\u1eabu m\u00e0 c\u00f2n gia t\u0103ng \u0111\u1ed9 ch\u00ednh x\u00e1c trong c\u00e1c x\u00e9t nghi\u1ec7m. Nh\u1edd \u0111\u00f3, b\u00e1c s\u0129 c\u00f3 th\u1ec3 theo d\u00f5i hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb, \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng lui b\u1ec7nh \u1edf m\u1ee9c \u0111\u1ed9 ph\u00e2n t\u1eed, ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i ph\u00e1t v\u00e0 \u0111\u01b0a ra c\u00e1c quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng ph\u00f9 h\u1ee3p, g\u00f3p ph\u1ea7n t\u1ed1i \u01b0u h\u00f3a ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb cho ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n\n\n\n

*T\u1eeb vi\u1ebft t\u1eaft:<\/strong>
ctDNA: DNA kh\u1ed1i u l\u01b0u h\u00e0nh tu\u1ea7n ho\u00e0n
ddPCR: droplet digital PCR
dPCR: digital PCR
EGFR: th\u1ee5 th\u1ec3 y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng bi\u1ec3u b\u00ec
NCCN: M\u1ea1ng l\u01b0\u1edbi Ung th\u01b0 To\u00e0n di\u1ec7n Qu\u1ed1c gia
NSCLC: Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf
UTPKTBN: Ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf<\/em><\/p>\n\n\n\n

<\/div>\n\n\n\n

5. T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/strong><\/strong><\/strong><\/h2>\n\n\n\n
    \n
  1. B\u1ed9 Y t\u1ebf. (2018). Quy\u1ebft \u0111\u1ecbnh s\u1ed1 4825\/Q\u0110-BYT v\u1ec1 vi\u1ec7c ban h\u00e0nh t\u00e0i li\u1ec7u chuy\u00ean m\u00f4n \u201cH\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf\u201d<\/em>. C\u1ed5ng th\u00f4ng tin Th\u01b0 vi\u1ec7n Ph\u00e1p lu\u1eadt. https:\/\/vnras.com\/quyet-dinh-4825-qd-byt-2018\/<\/a><\/li>\n\n\n\n
  2. National Comprehensive Cancer Network. (2025). NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer (Version 8.2025)<\/em>. NCCN.org.  https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/nscl.pdf<\/a><\/li>\n\n\n\n
  3. Nooreldeen, R., & Bach, H. (2021). Current and future development in lung cancer diagnosis<\/em>. International Journal of Molecular Sciences, 22<\/em>(8661). https:\/\/doi.org\/10.3390\/ijms22168661<\/a> Bi\u00ean d\u1ecbch: https:\/\/www.hoihohaptphcm.org\/TaiLieu\/CHAN%20DOAN%20UNG%20THU%20PHOI.pdf<\/a><\/li>\n\n\n\n
  4. Oscorbin, I. P., Smertina, M. A., Pronyaeva, K. A., Voskoboev, M. E., Boyarskikh, U. A., Kechin, A. A., Demidova, I. A., & Filipenko, M. L. (2022). Multiplex Droplet Digital PCR Assay for Detection of MET<\/em> and HER2<\/em> Genes Amplification in Non-Small Cell Lung Cancer. Cancers<\/em>, 14<\/em>(6), 1458. https:\/\/doi.org\/10.3390\/cancers14061458<\/a><\/li>\n\n\n\n
  5. Shong, L.YW., Deng, JY., Kwok, HH. et al.<\/em> Detection of EGFR<\/em> mutations in patients with suspected lung cancer using paired tissue-plasma testing: a prospective comparative study with plasma ddPCR assay. Sci Rep<\/em> 14<\/strong>, 25701 (2024). https:\/\/doi.org\/10.1038\/s41598-024-76890-0<\/a><\/li>\n\n\n\n
  6. Yin, J., Xia, L., Zou, Z., Zhuang, J., & Mu, Y. (2022). A direct and multiplex digital PCR chip for EGFR mutation. Talanta<\/em>, 250<\/em>, 123725. https:\/\/doi.org\/10.1016\/j.talanta.2022.123725<\/a><\/a><\/li>\n<\/ol>\n\n\n\n

    <\/p>","protected":false},"excerpt":{"rendered":"

    \u1ee8ng d\u1ee5ng PCR k\u1ef9 thu\u1eadt s\u1ed1 vi gi\u1ecdt (Droplet Digital PCR hay ddPCR) trong ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7y ti\u1ec1m n\u0103ng cho b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (non-small cell lung cancer).<\/p>","protected":false},"author":1,"featured_media":13777,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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Team","author_link":"https:\/\/abtvn.com\/en\/author\/admin\/"},"uagb_comment_info":0,"uagb_excerpt":"\u1ee8ng d\u1ee5ng PCR k\u1ef9 thu\u1eadt s\u1ed1 vi gi\u1ecdt (Droplet Digital PCR hay ddPCR) trong ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7y ti\u1ec1m n\u0103ng cho b\u1ec7nh nh\u00e2n ung th\u01b0 ph\u1ed5i kh\u00f4ng t\u1ebf b\u00e0o nh\u1ecf (non-small cell lung 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