经皮肺部肿瘤穿刺活检前后外周血循环肿瘤细胞变化的初步研究  

A preliminary study on the changes in peripheral blood circulating tumor cells before and after percutaneous transthoracic needle biopsy for lung tumors

作　　者：薛寒江 张毅[1] 卢高俊 钱坤[1] XUE Hanjiang;ZHANG Yi;LU Gaojun;QIAN Kun(Department of Thoracic Surgery,Xuanwu Hospital Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院胸外科,北京100053

出　　处：《中国临床新医学》2024年第12期1347-1351,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：首都卫生发展科研专项项目(编号:首发2022-2-2013)。

摘　　要：目的通过对比外周血循环肿瘤细胞(CTCs)在肺部肿瘤经皮穿刺活检前后的变化,探讨穿刺是否会引起肿瘤细胞入血。方法招募2019年12月至2023年12月首都医科大学宣武医院收治的疑似肺癌患者46例,均接受经皮肺穿刺活检,穿刺前及穿刺后接受CTCs检测(免疫磁珠负向富集+靶向聚合酶链反应),对比穿刺前后CTCs的变化。结果全部入组患者穿刺后的CTCs水平较穿刺前显著升高(P<0.05)。良性组11例穿刺前后CTCs水平变化不显著(P>0.05),恶性组35例穿刺后CTCs水平较穿刺前显著升高(P<0.05)。在恶性组,24例Ⅰ~Ⅲ期非小细胞肺癌及局限期小细胞肺癌组穿刺前后CTCs水平变化不显著(P>0.05),11例Ⅳ期非小细胞肺癌及广泛期小细胞肺癌组穿刺后CTCs水平较穿刺前显著升高(P<0.05)。结论穿刺活检可引起Ⅳ期非小细胞肺癌及广泛期小细胞肺癌患者CTCs水平升高,但对于Ⅰ~Ⅲ期非小细胞肺癌及局限期小细胞肺癌患者无明显影响。Objective To explore whether puncture can cause tumor cells to enter the bloodstream by comparing the changes in peripheral blood circulating tumor cells(CTCs)before and after percutaneous transthoracic needle biopsy for lung tumors.Methods A total of 46 patients with suspected lung cancer who were admitted to Xuanwu Hospital Capital Medical University from December 2019 to December 2023 were recruited,all of whom receiving percutaneous transthoracic needle biopsy.The patients received CTCs testing(immunomagnetic bead-based negative enrichment+targeted polymerase chain reaction)before and after puncture,and the changes in CTCs before and after puncture were compared.Results In all the enrolled patients,their levels of CTCs were significantly increased after puncture compared with those before puncture(P<0.05).In the benign tumor group,there were no significant changes in CTCs levels before and after puncture in 11 patients(P>0.05),while in the malignant tumor group,35 patients had significant increases in CTCs levels after puncture compared with those before puncture(P<0.05),and in the malignant tumor group,there were no significant changes in CTCs levels before and after puncture in 24 patients of the stageⅠ-Ⅲnon-small-cell lung cancer and limited-stage small-cell lung cancer group(P>0.05),while CTCs levels after puncture in 11 patients of the stageⅣnon-small-cell lung cancer and extensive-stage small-cell lung cancer group were significantly increased compared with those before puncture(P<0.05).Conclusion Percutaneous transthoracic needle biopsy can cause the increased levels of CTCs in patients with stageⅣnon-small-cell lung cancer and extensive-stage small-cell lung cancer,but has no significant effect on patients with stageⅠ-Ⅲnon-small-cell lung cancer and limited-stage small-cell lung cancer.

关 键 词：肺癌 良性肿瘤 循环肿瘤细胞 经皮肺穿刺活检 肿瘤分期 

分 类 号：R734.2[医药卫生—肿瘤]