Optimal preservation condition for the extraction of cell-free DNA from bile of patients with biliary tract cancer

Background: Patients with biliary tract cancer (BTC) often have dismal outcomes due to the poor performance of traditional methods for early diagnosis. Recently, bile cell-free DNA (cfDNA) has been reported as a potential liquid biopsy material for BTC diagnosis. However, bile is a complex alkaline aqueous medium, and the proper storage conditions for bile remain to be explored. The aim of this study is to explore the effects of storing bile under various conditions on the stability of bile cfDNA and to determine the optimal conditions, thereby establishing a foundation for the subsequent application of bile cfDNA in liquid biopsy for early diagnostic and prognosis monitoring of patients with malignant BTC.

Methods: We evaluated the storage temperature and storage time for the preservation of bile samples. Bile samples were collected in cfDNA tubes with protectant covered inside or regular tubes without, and the stability of bile cfDNA was analyzed during 10 days at room temperature (RT) or after 2 months of storage at low temperatures.

Results: Bile cfDNA remained stable for bile samples being collected with cfDNA tubes and stored for 10 days at RT, while degraded with time for the case with regular tubes. When bile samples were collected with cfDNA tubes and stored for 2 months at 4 ℃, bile cfDNA remained stable, however, if collected with regular tubes, bile cfDNA exhibited a slight loss of integrity. No significant difference was observed for 2 months storage at -20 or -80 ℃.

Conclusions: Our findings suggested that for bile cfDNA research, bile samples should be collected with cfDNA tubes and it can be transported for short-term shipment at RT, and could be stored at 4 ℃ with cfDNA tubes, or frozen at -20 ℃ with regular tubes.