膀胱癌不同TNM分期患者外周血循环肿瘤细胞的表达探索  

Study of the expression of CTCs in patients with bladder cancer at different TNM stages

作　　者：张蒙[1] 陆伟[1] 王永强[1] 方露[2] 蔡志明[1] 吴松[1] 

机构地区：[1]安徽医科大学深圳市第二人民医院临床医学院泌尿外科,广东深圳518000 [2]安徽医科大学第二附属医院泌尿外科,合肥230000

出　　处：《中华临床医师杂志（电子版）》2015年第19期53-56,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家重点基础研究发展计划("973"项目:2014CB745200);深圳基础研究项目(JCYJ20130401114928183;JCYJ20130401114715714)

摘　　要：目的研究不同TNM分期膀胱癌患者外周血循环肿瘤细胞（cTCs）的表达情况，探讨免疫芯片分选法的可行性，评估检测结果的临床意义。方法2014年6月至2015年2月收治的T1～T4不同分期膀胱癌患者15例，其中男12例，女3例。年龄48~78岁，平均62岁。依据2009年UICC的TNM分期标准：T1期5例，T2期5例，T3期3例，T4期2例，淋巴结转移2例。所有患者均无远处转移，均行膀胱癌根治手术。且于治疗前采取外周血7．5ml，0～4℃ADC管内保存，24h内送检。用免疫芯片分选法对患者外周血进行CTC定量检测，选用抗细胞角蛋白CK8／18／19荧光抗体作为筛选标记物。结果4例膀胱癌患者外周血CTC定量检测为阳性（T1～T4期各1例），共发现6个CK8／18／19阳性的细胞，并在1例分期为T1N0M0的患者外周血中检测到3个CTCs。结论本研究并未发现肿瘤分期与CTC检出率有关。抗CK8／18／19抗体可以作为免疫芯片分选法检测膀胱癌CTC的标记物。Objective To explore the expression of CTCs in bladder cancer patients with different TNM stage and the feasibility of the sorting method based on immunology on microfluidic chip, evaluating the clinical significance of these results. Methods Fifteen patients with bladder cancers （T1-T4） hospitalized in the urology department for further clinical evaluation in Jun. 2014 to Feb. 2015 were enrolled in this study. There were 12 males and 3 females with mean age of 62 （48-78） years. According to staging criteria of UICC in 2009, there were 5 cases in T1 stage, 5 cases in T2, 3 cases in T3 stage, 2 cases in T4 stage, and 2 cases turn up with lymphatic metastasis. All the patients received radical cystectomy, and none of these patients appeared distant metastases. Then, 7.5 ml peripheral blood samples were collected from these patients and preserved in test tube at the temperature of 15~30℃. The tests should be done within 24 hours after the blood sample drawn. We selected fluorescent anti-CK8/18/19 antibodies as the CTC detection makers for bladder cancer. And the number of CTC was quantitative detected by immunology on Microfluidic chip method. Results Quantitative test results of CTC in four patients with bladder cancer were positive （one case, each stage）. Overall, total six CK8/18/19 positive cells were identified in four patients. Besides, three CTCs were detected in one patient with TNM stage T1NOM0. Conclusion Our study can not provide any evidence to prove that the detection rate of CTCs related to the TNM stage. And the anti-CK8/18/19 antibody can be used in testing circulating tumor cells in patients with bladder cancer by immunology on mierofluidie chip.

关 键 词：膀胱肿瘤 肿瘤循环细胞 CK8/18/19抗体 

分 类 号：R737.14[医药卫生—肿瘤]