非小细胞肺癌术后外周血循环肿瘤细胞的检测及其意义  

Significance of detecting circulating tumor cells in peripheral blood of postoperative patients with non-small cell lung cancer

作　　者：杜开齐 朱有才 杨勇 张志豪 徐朱慧 李晓峰 

机构地区：[1]武警浙江总队嘉兴医院胸心外科,314000 [2]武警浙江总队嘉兴医院检验科,314000

出　　处：《武警医学》2013年第9期786-787,791,共3页Medical Journal of the Chinese People's Armed Police Force

基　　金：浙江省科技厅公益性技术应用研究计划项目(编号:2012C33022)

摘　　要：目的探讨对非小细胞肺癌术后外周血中循环肿瘤细胞(circulating tumor cells,CTCs)的检测及意义。方法经根治手术治疗并经病理确诊的肺腺癌患者38例,术后TNM分期为Ⅰ期19例,Ⅱ期6例,Ⅲ期13例。10例肺良性病变患者作为对照组,术后病理为肺结核4例,肺部炎性病变6例。采用免疫磁珠富集联合流式细胞术方法检测外周血CTCs(每7.5ml)。结果 10例肺良性病变患者术后外周血中CTCs阳性率为10%(1/10),38例非小细胞肺癌患者术后外周血中CTCs阳性率为39.5%(15/38)。肺良、恶性组CTCs阳性率比较差异无统计学意义(P=0.132)。Ⅰ期与Ⅲ期CTCs阳性率相比差异具有统计学意义(χ2=3.970,P=0.046)。结论非小细胞肺癌术后外周血中存在CTCs,其阳性率与肿瘤TNM分期相关。CTCs检测可用于指导术后治疗。Objective To investigate the significance of detecting circulating tumor cells（CTCs） in peripheral blood of postoperative patients with non -small cell lung cancer（NSCLC）. Methods Thirtyeight patients with lung adenocarcinoma diagnosed by pathology and treated by radical surgery, were staged by TNM staging criteria,including stage I 19 cases, stage II 6 cases, and stageⅢ 13 cases. Ten patients with lung benign disease served as control group; they were diagnosed by postoperative pathology（4 cases with tuberculosis, 6 cases with lung inflammatory lesions）. CTCs in peripheral blood（ every 7.5 ml）were detected by the method of immune magnetic bead - based rare cell enrichment system combined with flow cytometry. Results The positive rate of peripheral blood CTCs was 10% （1/10）in lung benign disease patients and 39.5% （15/38） in NSCLC patients： There was no difference in CTCs positive rate between lung benign disease patients and NSCLC patients（ P = 0. 132）. There was difference in CTCs positive rate between stage patients and m stage patients（x2 = 3. 970,P = 0.046）. Conclusions CTCs can be detected in peripheral blood of postoperative NSCLC patients and can be used to guide the therapy. The positive rate of CTCs is related to TNM staging.

关 键 词：肺癌 手术 循环肿瘤细胞 

分 类 号：R687.2[医药卫生—骨科学]