非小细胞肺癌循环肿瘤细胞的定量检测意义  

Detection and quantitation of circulating tumor cells in patients with non-small cell lung cancer

作　　者：刘志东[1] 许绍发[1] 李云松[1] 李福根[1] 刘树库[1] 韩毅[1] 宋小运[1] 梁子昆[1] 

机构地区：[1]北京胸科医院外科,101149

出　　处：《中华胸心血管外科杂志》2009年第3期184-186,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨定量检测非小细胞肺癌病人肺静脉和外周静脉血循环肿瘤细胞与临床分期、治疗及预后监测的相关性。方法选择25例非小细胞肺癌病人，10例良性肺疾病者（对照组）、健康志愿者10位。经CD326免疫磁珠阳性分选富集循环肿瘤细胞（CTCs）标本后，行CK-FITC、CD45PE荧光抗体标记，应用多参数流式细胞仪对CTCs进行定量检测。结果25例非小细胞肺癌病人术中肺静脉血CTCs定量检测阳性率为64％（16／25例），明显高于外周静脉血CTCs阳性率40％（10／25例）的水平（P〈0．05）；Ⅰ期13例中外周血CTCs阳性3例（23．0％），肺静脉血CTCs阳性8例（61．5％）。结论非小细胞肺癌CTCs水平的定量检测是较为敏感的肿瘤进展、治疗反应和预后预测的评价指标；免疫磁珠富集联合流式细胞分析技术检测CTCs的敏感性和特异性较高，具有一定的临床应用前景。Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells （CTCs） in NSCLC. Methods Twenty-five patients who underwent surgical resection for NSCLC form Jan 2007 to Apt 2007 were included in this study. C, entrol group included 10 patients with benign pulmonary diseases （2 ease of hamartoma and 8 ease of pulmonary tuberculosis） and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetie beads and CK-fluorescein isothioeyanate （CK-FITC） were served as the marker antibodies of CTCs. Firstly manonuclear cell marked by mintheads conjugated with CD326, the mononuelear cells were enriched and separated though Magnetic-activated cell separation （MACS）, then the positive separation cells were marked by anti-CK-FITC and anti-lenkocyte antibody CD45-phyea- erythrine （anti-CD45-PE）, finally those cells detected and analyzed by flow eytornetry. Results For stage Ⅰ and stage Ⅱ patients （n= 16）, CTCs were detected from peripheral vein blood of in 5 （5/16, 31.25% ） and from pulmonary veins blood in 9 （9/16, 56.25% ）. For stage Ⅲ and stage Ⅳ, CIEs were detected from peripheral vein blood in 5 （5/9, 55.56% ） and from puhnanary veins blood in 9 （7/9, 77.78% ）. For stage Ⅰ, CTCs were detected from peripheral vein blood in 3 （3/13, 23% ） and from pulmonary veins blood in 8 （8/13, 61.54% ）. The whole CTCs positive detection rate from pulmonary veins blood was 64% （16/25） which higher than from peripheral vein bloed（40%, 10/25）（P〈0.05）. Conclusion The methed was set up by MACS eombined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients with NSCLC, MACS combined with FCM may improve detection rate of CTCs. This technique appears to be an efficient to detect circulating tumor cells and may be important for clinical practice in the future.

关 键 词：癌 非小细胞肺 肿瘤循环细胞 免疫磁化分离 

分 类 号：R686[医药卫生—骨科学]