化疗前后肺癌患者外周循环癌细胞数的动态观察  

Observation of circulating tumor cells in patients with lung carcinoma by real-time fluorescent quantitative-PCR approach before and after chemotherapy

作　　者：王梅[1] 葛明建[2] 

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016 [2]重庆医科大学附属第一医院胸外科,重庆400016

出　　处：《重庆医科大学学报》2008年第5期526-530,535,共6页Journal of Chongqing Medical University

基　　金：重庆市卫生局科研基金资助(合同号：00-2004)

摘　　要：目的:本实验观察32例肺癌患者化疗前后外周循环癌细胞数(CTCs)的动态变化,以寻找新化疗的疗效评判标准。方法:分别于化疗前及化疗1周期后、第3周收集32例肺癌患者外周血标本。同时行胸片或胸部CT扫描,并计算肿瘤的大小。运用实时荧光定量逆录-聚合酶链反应(fqRT-PCR)法定量检测外周血中CK19基因的表达。结果:化疗后CTCs水平显著降低(P=0.000 1)。化疗前小细胞肺癌(Small cell lung cancer,SCLC)患者外周血CK19 mRNA水平明显高于非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者(P=0.041)。治疗前后CK19 mRNA测值变化与瘤负荷间存在正相关(P=0.000)。结论:在治疗过程中,运用fqRT-PCR法对肺癌患者CTCs进行定量监测是可行的。通过动态检测可及时评价化疗反应,有助于在早期阶段即对患者设计更合理、更有针对性的治疗方案。Objective：In order to develop a new standard of curative effect, this study was designed to track the number of CTCs in patients with lung cancer during chemotherapy. Methods： Samples of peripheral blood was taken from each lung cancer patients（n=32） on the day before chemotherapy as well as the third week after the chemotherapy cycle. The samples were subjected to real-time fqRT-PCR. Meanwhile the tumour size was determined by chest X-ray or computed tomograghy. Results：Compared to that of pre-chemotherapy, the expression level of CK19 in the patients significantly declined after chemotherapy（t=4.659,P=0.000 1 ）. The level of CK19 mRNA in patients with SCLC was higher than that of patients with NSCLC（t=1.944,P=0.041 ）. The change of CK19 mRNA correlated well with the type during the treatment. Relatively the shift of SCLC is more obvious（t=6.073,P=0.000 1）. Conclusions：The real-time fluorescent quantitative-PCR approach is useful for measuring the relative number of CTCs in a patients＇ peripheral blood to monitor the effectiveness of treatment,and for designing more comprehensive and reasonable therapeutic regimes at earlier dates for patients.

关 键 词：肺肿瘤 聚合酶链反应 细胞角蛋白 信使RNA 化学治疗 

分 类 号：R734.2[医药卫生—肿瘤]