配体靶向多聚酶链反应法检测非小细胞肺癌患者胸腔积液中肿瘤细胞水平的临床价值  

Evaluation of Ligand-targeted PCR Method in Detecting Tumor Cell Levels in Pleural Effusion of Patients with Non-small Cell Lung Cancer

作　　者：纪子梅 梅晓冬[1] 费广茹[1] 郭欣[1] 蒋旭琴[1] 

机构地区：[1]安徽省立医院呼吸内科,合肥230001

出　　处：《肿瘤防治研究》2016年第3期226-229,共4页Cancer Research on Prevention and Treatment

摘　　要：目的评价初诊非小细胞肺癌（non-small cell lung cancer,NSCLC）患者胸腔积液中肿瘤细胞（tumor cell,TC）水平的临床价值。方法收集2013年1月~2013年12月安徽省立医院呼吸内科50例初诊NSCLC合并胸腔积液患者的首次胸腔积液标本,采用配体靶向多聚酶链反应（ligand-targeted polyenzyme chain reaction,LT-PCR）检测胸腔积液中的肿瘤细胞水平。分析胸腔积液中肿瘤细胞水平与患者性别、年龄、病理类型等临床特征以及身体状况（performance status,PS）评分、胸腔积液中癌胚抗原（carcino-embryonic antigen,CEA）水平、转移部位数量的关系,同时,比较该方法与常规脱落细胞学检查之间的阳性诊断率。结果初诊NSCLC患者胸腔积液中肿瘤细胞水平与患者性别、年龄、病理类型无明显相关性（P〉0.05）,与患者PS评分呈正相关,PS分值越高、转移部位越多的患者肿瘤细胞水平也越高（P〈0.01）。胸腔积液中肿瘤细胞水平和CEA水平呈显著正相关（r=0.667,P〈0.01）。胸腔积液脱落细胞学检查阳性组患者的肿瘤细胞水平显著高于阴性组患者[（261.74±272.44）/ml vs.（90.61±144.24）/ml,P〈0.01]。部分肿瘤细胞水平显著增高的患者,常规细胞学检测为阴性。结论 NSCLC患者胸腔积液中肿瘤细胞水平定量检测方法较传统的脱落细胞病理学检查方法可能有较高的诊断效率,对肺癌合并胸腔积液的诊断以及预后的评估有一定的参考价值。Objective To evaluate the clinical value of ligand-targeted PCR method in detecting tumor cell（TC） levels in the pleural effusion of patients with non-small cell lung cancer（NSCLC）. Methods We enrolled 50 NSCLC patients who were initially diagnosed as NSCLC with pleural effusion from January to December 2013 in Anhui Provincial Hospital. The samples of pleural effusion from each patient were collected and tumor cell levels in the pleural effusion were detected by circulating cell detecting system. The correlations between the tumor cell level and clinical characteristics, pathological category, performance status（PS） score, carcino-embryonic antigen（CEA） level and metastasis status were analyzed. The diagnostic positive rate of CTC detection method was compared with that of routine cytological examination method. Results The TC level in pleural effusion was not correlated to gender, age or pathological types（P〈0.05）. The patients with 3 points in PS score had a higher TC levels in pleural effusion than those with 0, 1 and 2 points（P〈0.01）. TC level was positively correlated to CEA in pleural effusion（r=0.667, P〈0.01） and the numbers of metastatic sites（P〈0.01）. TC level was also significantly higher in patients with positive cytological examination than that in negative group[（261.74±272.44）/ml vs.（90.61±144.24）/ml, P〈0.01]. Notably, in some patients whose TC level was increased remarkably, routine cytological examination was negative. Conclusion Ligand-targeted PCR method might be more efficient than exfoliated cell examinations method in detecting tumor cell level in the pleural effusion of NSCLC patients, and helpful for differential diagnosis and prognosis assessment.

关 键 词：非小细胞肺癌 胸腔积液 配体靶向多聚酶链反应(LT-PCR) 

分 类 号：R730.43[医药卫生—肿瘤] R734.2[医药卫生—临床医学]