循环肿瘤细胞分型与非小细胞肺癌临床病理特征相关性研究  

Correlation between types of circulating tumor cells and clinicopathological features of patients with non-small cell lung cancer

作　　者：黄祥奇 李文娟[2] 梁静 潘宇航[1] 陈健宁[1] 何丹[1] Huang Xiangqi;Li Wenjuan;Liang Jing;Pan Yuhang;Chen Jianning;He Dan(Department of Pathology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院病理科,广州510630 [2]中山大学附属第三医院呼吸与危重症医学科,广州510630

出　　处：《新医学》2020年第12期933-938,共6页Journal of New Medicine

基　　金：国家自然科学基金(81702409);广东省自然科学基金(2017A030310062)。

摘　　要：目的探讨不同类型循环肿瘤细胞(CTC)与非小细胞肺癌(NSCLC)临床病理特征的相关性。方法选取121例NSCLC患者(NSCLC组)作为研究对象,另以40例非肿瘤肺部良性病变患者(良性病变组)和10名健康志愿者(健康对照组)作为对照。采集所有患者静脉血,使用纳米膜富集技术过滤分离CTC,再用mRNA多重原位杂交法分析检测CTC上皮或间质基因,比较不同组CTC阳性率的差异,探讨NSCLC患者CTC与临床病理特征的相关性。结果NSCLC组患者的CTC阳性率为86%,其中上皮型、混合型、间质型阳性率分别为31%、74%及23%;良性病变组的CTC阳性率为15%,其中上皮型、混合型、间质型阳性率分别为3%、15%及0%,健康对照组未检出CTC。NSCLC组CTC阳性率及混合型CTC阳性率均高于良性病变组及健康对照组(P均<0.017)。121例NSCLC患者中,临床分期高(Ⅲ~Ⅳ期)者的CTC阳性率高于临床分期低(Ⅰ~Ⅱ期)者,有淋巴结转移(N1~N3)者的CTC阳性率高于无淋巴结转移者(N0)者(P均<0.05)。Spearman秩相关分析显示,CTC总数与临床分期呈正相关(rs=0.254,P=0.005),其中上皮型CTC(r=0.202,P=0.026)、混合型CTC(rs=0.247,P=0.006)的数量均与临床分期呈正相关,而间质型CTC与临床分期无关(P>0.05)。CTC总数与淋巴结转移呈正相关(rs=0.218,P=0.016),其中混合型CTC的数量与淋巴结转移的发生呈正相关(rs=0.247,P=0.006),而上皮型CTC及间质型CTC的数量与淋巴结转移并无关(P均>0.05)。结论NSCLC患者CTC阳性率与肿瘤分期及淋巴结转移有关,可考虑作为临床分期及预后评估的附加指标。Objective To explore the correlation between different types of circulating tumor cells(CTCs)and the clinicopathological features of patients with non-small cell lung cancer(NSCLC).Methods In total,121 NSCLC patients were assigned into the NSCLC group,40 patients with benign lung diseases into the benign lung disease group and 10 healthy volunteers into the control group,respectively.The venous blood of all patients was collected,and the epithelial or mesenchymal genes of CTCs in the peripheral blood were detected by Nanofilm enrichment technology and multiple mRNA-ISH analysis.The positive rates of CTCs were statistically compared among different groups.The correlation between CTCs type and clinicopathological characteristics in the peripheral blood of NSCLC patients was analyzed.Results In the NSCLC group,the positive rate of CTCs was 86%,and the positive rates of epithelial,biophenotypic and mesenchymal CTCs were 31%(38/121),74%(90/121)and 23%(24/121),respectively.The positive rates of epithelial,biophenotypic and mesenchymal CTCs in the benign lung lesion group were 3%(3/40),15.0%(6/40)and 0%(0/40),respectively.No CTCs were detected in the healthy volunteers.The positive rate of CTCs and biophenotypic CTCs in the NSCLC group were significantly higher compared with those in the benign lung lesion and healthy control groups.Among 121 NSCLC patients,the positive rate of CTCs in patients with stageⅢandⅣNSCLC was significantly higher than that in their counterparts with stageⅠandⅡNSCLC,and the positive rate of CTCs in patients with lymph node metastasis(N1-N3)was remarkably higher than that in those without lymph node metastasis(N0)(both P<0.05).Spearman correlation analysis demonstrated that the total count of CTCs was positively correlated with clinical staging(rs=0.254,P=0.005).The count of epithelial and biophenotypic CTCs was positively associated with clinical staging(rs=0.202,P=0.026;rs=0.247,P=0.006),whereas that of mesenchymal CTCs was not correlated with clinical staging(P>0.05).The total count o

关 键 词：非小细胞肺癌 循环肿瘤细胞 临床病理特征 

分 类 号：R734.2[医药卫生—肿瘤]