非转移性非小细胞肺癌患者循环肿瘤细胞与临床病理特征的关系  

Relationship between circulating tumor cells and clinicopathologic features in non-metastatic nonsmall cell lung cancer

作　　者：范军振 吕亚莉[1] 王波[2] 宋欣[1] 钟梅[1] 王琼[1] 朱凤伟[1] 刘星 石怀银[1] FAN Jun-zhen;LV Ya-li;WANG Bo;SONG Xin;ZHONG Mei;WANG Qiong;ZHU Feng-wei;LIU Xing;SHI Huai-yin(Department of Pathology;Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing 100853, China;Cyttel Bioseienees Inc., Beijing 101111, China)

机构地区：[1]解放军总医院病理科,北京100853 [2]解放军总医院胸外科,北京100853 [3]莱尔生物医药科技有限公司,北京101111

出　　处：《诊断病理学杂志》2018年第4期281-284,288,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨非转移性非小细胞肺癌患者(NMNSCLC)外周血循环肿瘤细胞(CTCs)检测的临床意义及与临床病理特征的关系。方法 52例病理确诊的非转移性非小细胞肺癌患者(45例腺癌、7例鳞癌)为实验组,病理分期:Ⅰ期8例,Ⅱ期26例,Ⅲ期18例;35例健康体检者为对照组。采用Cyttel■CTC检测技术(即免疫磁微粒阴性富集技术结合免疫荧光原位杂交技术)检测外周血CTCs(每3.2 ml),分析CTCs与NMNSCLC患者临床病理特征的关系。结果 52例NMNSCLC检测显示,CTCs阳性率为78.8%(41/52),35例健康者均未检出CTCs,两组间差异显著(P<0.001)。其中实验组Ⅰ期CTCs阳性率为37.5%,Ⅱ期阳性率为81.5%,Ⅲ期阳性率为94.4%,CTCs计数在3个不同分期间分布具有差异(P<0.05a)。发生淋巴结转移者CTCs阳性率为100%,高于未发生淋巴结转移者(74.4%),但无明显差异(P>0.05);T1期(17/22,77.3%)和T2期(13/17,76.5%)患者CTCs阳性率差异不显著(P>0.05);腺癌患者CTCs阳性率为76.2%(32/42),鳞状细胞癌阳性率为85.7%(6/7),两组比较无显著差异(P>0.05);低分化、中分化、高分化组阳性率分别为77.8%、78.6%和85.7%,在不同分化程度间CTCs阳性率差异不显著(P>0.05)。结论采用Cyttel■CTC检测技术可有效检测NMNSCLC患者外周血CTCs,此技术有望成为一种实用的CTCs检测技术;CTC计数分布与NMNSCLC患者的病理分期显著相关,与淋巴结转移成正相关,与患者性别、年龄、病理亚型、分化程度、T分期均无显著相关性。Objective This study investigated the significance of circulating tumor cells（ CTCs） in peripheral blood of patients with non-metastatic non-small cell lung cancer（ NMNSCLC） and the relationship between CTCs and clinicopathologic features of NMNSCLC. Methods The experimental group including 52 patients with pathologically diagnosed non-metastatic non-small cell lung cancer patients（ 8 stage Ⅰ,26 stage Ⅱ and 18 stage Ⅲ of 45 adenocarcinoma and 7 squamous cell carcinomas） were recruited from our hospital. And 35 healthy donors from our hospital outpatient were selected as control group. CTCs were detected by negative enrichment and immunofluorescence in situ hybridization platform（ Cyttel ）. Correlation of NMNSCLC CTCs with clinicopathological features were analysed. Results CTCs were detected in 78. 8%（ 41/52） non-metastatic non-small cell lung cancer patients and not detected in 35 healthy controls.The difference between NMNSCLC patients and the control cohort was statistically significant（ P 0. 001）. And 37. 5% of stage I,81. 5% of stage II and 94. 4% of stage IV patients were found to have CTC ≥ 1/3. 2 ml（ P = 0. 020）.Furthermore,the incidence of CTCs was different between the lymph node metastasis positive（ 100%） and negative groups（ 74. 4%,P = 0. 170）. However,there was not significant difference in CTC positive rate between the groups of T staging（ 77. 3% in T1 vs. 76. 5% in T2,P = 0. 701）,pathological subtype（ 76. 2% in adenocarcinoma vs. 85. 7% in squamous cell carcinoma,P = 0. 358） and tumor differentiation（ 77. 8%,78. 6% and 85. 7% in low,medium and high differentiation groups,P = 0. 551）. Conclusion Cyttel CTC detection technology,which can effectively detect peripheral CTCs in non-metastatic non-small cell lung cancer,is expected to become a practical detection technology of circulating tumor cells.CTCs are significantly associated with the pathological staging of non-metastatic non-small cell lung cancer patients,and are positively related to lym

关 键 词：循环肿瘤细胞 非转移性非小细胞肺癌 临床病理特征 

分 类 号：R734.02[医药卫生—肿瘤]