循环肿瘤细胞分型检测及其在晚期肺癌中的临床应用研究  

Typing detection of circulating tumor cells and its clinical application in advanced lung cancer

作　　者：周政 孟凡萍 赵丹 牛晓昶 范慧 李思颖 康菊香 赵昕 ZHOU Zheng;MENG Fanping;ZHAO Dan;NIU Xiaochang;FAN Hui;LI Siying;KANG Juxiang;ZHAO Xin(Department of Clinical Laboratory,Chongqing University Three Gorges Hospital,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院检验科,重庆404000

出　　处：《国际检验医学杂志》2021年第15期1874-1879,共6页International Journal of Laboratory Medicine

摘　　要：目的对晚期肺癌患者外周血循环肿瘤细胞(CTCs)的数量和分型进行检测、分析,探讨其与患者临床特征的关系。方法收集43例晚期肺癌患者的临床资料。基于CanPatrolCTCs分型检测平台,通过RNA原位杂交技术及分子DNA技术荧光标记特异信使RNA(mRNA),将患者外周血中CTCs分为上皮型、混合型、间质型3种亚型,分析其与患者临床特征的关系。结果43例晚期肺癌患者的CTCs阳性率为100.0%,其中上皮型CTCs、混合型CTCs和间质型CTCs的阳性例数分别是33例、42例和34例,阳性率分别为76.7%、97.7%和79.1%。总CTCs和各亚型CTCs在患者各临床特征(肿块位置、肺叶分布、临床分期、病理亚型)间的差异无统计学意义(P>0.05)。发生器官转移的患者共30例,其中27例为肺外转移。有肺外转移的患者与无肺外转移的患者,上皮型CTCs、混合型CTCs、总CTCs数量差异有统计学意义(P<0.05)。结论晚期肺癌患者外周血中CTCs的数量及分型与是否发生肺外转移有关,其中混合型CTCs可能为晚期肺癌患者发生远处转移提供线索。此外,CTCs的分型检测可用于发现CTCs转移的器官偏向性,与CTCs的动态监测结合,可进一步推动晚期肺癌精准诊疗的发展。Objective To detect and analyze the number and type of circulating tumor cells(CTCs)in peripheral blood of the patients with advanced lung cancer,and to investigate their relationships with the clinical characteristics.Methods The clinical data of 43 patients with advanced lung cancer were collected.Based on the CanPatrolCTCs typing detection platform,specific messenger RNAs(mRNA)were fluorescently labeled by using RNA in situ hybridization technique and molecular DNA technique.The peripheral blood CTCs were divided into the three subtypes of epithelial,mixed and interstitial types,and their relationships with the clinical characteristics of the patients were analyzed.Results The CTCs positive rate in 43 cases of advanced lung cancer was 100.0%,in which the epithelial type,mixed type and interstitial types were in 33 cases,42 cases and 34 cases respectively,and their positive rates were 76.7%,97.7%and 79.1%respectively.The differences in clinical characteristics(tumor location,pulmonary lobe distribution,clinical stage and pathological subtype)between the total CTCs and various subtypes had no statistical significance(P>0.05).The organ metastasis occurred in 30 cases,in which 27 cases were extrapulmonary metastasis.The numbers of epithelial CTCs,mixed CTCs and total CTCs had statistical difference between the patients with extrapulmonary metastasis and the patients with non-pulmonary netastasis(P<0.05).Conclusion The number and type of CTCs in the peripheral blood of the patients with advanced lung cancer are correlated with extrapulmonary metastasis occurrence,in which the mixed CTCs may provide the clues for the distant metastasis of the patients with advanced lung cancer.In addition,the typing detection of CTCs can be used to find the organ bias of the CTCs metastasis.Its combination with the dynamic monitoring of CTCs can further promote the development of precision diagnosis and treatment for advanced lung cancer.

关 键 词：循环肿瘤细胞 肺癌 临床分期 肺外转移 

分 类 号：R446.69[医药卫生—诊断学]