循环肿瘤细胞在评估传统及胸腔镜辅助肺癌切除术治疗早期非小细胞肺癌效果的应用  

Application of Circulating Tumor Cells in Evaluating the Efficacy of Traditional and Thoracoscopic-assisted Lung Cancer Resection in the Treatment of Early Stage Non-small Cell Lung Cancer

作　　者：屈志刚[1] 李金波[1] 胡亚锋[1] 伍光[1] 田彦 QU Zhi-gang;LI Jin-bo;HU Ya-feng;WU Guang;TIAN Yan(Department of Cardiothoracic Surgery,Zhuozhou City Hospital,Zhuozhou,Hebei 072750,China;Department of Obstetrics and Gynecology,Zhuozhou City Hospital,Zhuozhou,Hebei 072750,China)

机构地区：[1]涿州市医院心胸外科,河北涿州072750 [2]涿州市医院妇产科,河北涿州072750

出　　处：《解放军医药杂志》2020年第10期58-61,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省保定市科技支撑计划(17ZF293)。

摘　　要：目的观察循环肿瘤细胞(CTCs)在非小细胞肺癌(NSCLC)患者围术期行传统手术、单孔及三孔法胸腔镜辅助肺癌切除(VATS)过程中的变化。方法共纳入2014年8月—2018年2月NSCLC患者61例,根据手术方式分为传统手术组24例、单孔及三孔VATS组分别16例及21例。3组分别于术前2 d、手术当日及术后2 d采集外周血标本,通过免疫磁珠法富集、Envision法检测CTCs,并分析其变化。结果61例中共44例检测出CTCs,检测阳性率为72.1%。术后2 d传统手术组CTCs数量高于单孔及三孔VATS组(P<0.05)。传统手术组术前2 d至术后2 d CTCs数量增高情况高于单孔及三孔VATS组(P<0.01),而三孔VATS组CTCs数量增高最少。结论外科肺癌切除术均带来围术期CTCs释放入血,而三孔VATS较少引起CTCs的增加,可能降低肿瘤的复发转移风险。Objective To observe the changes of circulating tumor cells(CTCs)in patients with non-small cell lung carcinoma(NSCLC)undergoing conventional resection,single-port and three-port video-assisted thoracoscopic surgery(VATS)for lung cancer resection during perioperative period.Methods A total of 61 patients diagnosed with NSCLC during August 2014 and February 2018 were enrolled in this study.According to different surgical methods,they were divided into the conventional lung cancer resection group(n=24),the single-port VATS group(n=16)and three-port VATS group(n=21).Peripheral blood samples from three groups were collected at 2 d prior to surgery,on the day of surgery,and at 2 d after surgery.CTCs were measured by immunomagnetic bead method and Envision detection technique,and the changes were analyzed.Results Forty-four of 61 patients(72.1%)were positive for CTCs before surgery.The number of CTCs at 2 d after surgery was significantly larger in conventional resection group than single-port and three-port VATS groups(P<0.05).The number of CTCS in traditional resection group was higher than that in single-port and three-port VATS groups from 2 d before operation to 2 d after operation(P<0.01).In addition,the increase in the number of CTCS was the smallest in three-port VATS group.Conclusion Lung cancer resection will bring about the release of CTCs into the blood during the perioperative period,while the three-port VATS method rarely causes the increase of CTCs,which may reduce the recurrence and metastasis of tumor.

关 键 词：癌 非小细胞肺 肿瘤细胞 循环 肺切除术 胸腔镜外科手术 围术期 

分 类 号：R734.2[医药卫生—肿瘤]