自体CIK细胞治疗对老年非小细胞肺癌患者循环肿瘤细胞EMT的影响

目的 探讨自体细胞因子诱导的杀伤细胞（CIK）细胞治疗对老年非小细胞肺癌患者循环肿瘤细胞上皮间质转化（EMT）的影响.方法 应用免疫磁珠分选循环肿瘤细胞;实时荧光定量逆转录-聚合酶链反应（RT-PCR）检测EMT标记物CK19、E-cadherin、Vimentin、SnaiI在CIK治疗前后的表达变化,分析其与临床病理特征的关系,比较CIK治疗前后患者卡氏行为状态（KPS）评分的变化.结果 40例肺癌患者中,上皮细胞标志物CK19、E-cadherin的mRNA阳性表达率分别是90％（36/40）和17.5％（7/40）,间质细胞标记物Vimentin、Snail的mRNA阳性表达率分别是60％（24/40）和62.5％（25/40）.CK19、Vimentin、Snail的阳性表达率与性别无关（P＞0.05）,与肿瘤的大小、病理分型、分期、淋巴结转移、血行转移明显相关（P＜0.05）.E-cadherin的阳性表达率极低,与临床病理特征均无相关性.CIK治疗后CK19、E-cadher、Vimentin、Snail的mRNA阳性表达率均显著下降,分别为62.5％（25/40）、0％（0/40）、20％（8/40）、10％（4/40）,而且CIK治疗后患者KPS评分显著提高（P＜0.05）.结论 老年肺癌患者循环肿瘤细胞存在EMT,并与肿瘤进展正相关,自体CIK细胞治疗抑制了EMT,并提高了患者的生活质量.

Objective To investigate the effect of CIK on the epithelial- mesenchymal transition （ EMT ） of circulating tumor cells in elderly patients with non-small cell lung cancer. Methods Immunomagnetic separation technique has been applied toisolate CTCs. The EMT markers mRNA expression has been identified by Real-time RT-PCR. The relationship between the expressions of EMT markers and clinicopathological features were analyzed. The KPS scores were also detected before and after CIK cell therapy. Result S The positivity rate of EMT markers is 90% （ 36/40, CK19 ） , 17.5% （ 7/40, E-cadherin ） , 60 % （ 24/40, Vimentin ） , and 62.5% （ 24/40, Snail ） respectively; There was significant correlation between the expression of CK19, Vimentin and Snail mRNA expressions with the tumor size, lymph node metastasis, venous invasion, pathological type and clinical staging （ P〈0.05 ） ; CIK therapy significantly decreased the mRNA positivity rate （ CK19, 62.5%; E-cadherin, 0%; Vimentin, 20%, Snail, 10% ） , furthermore, CIK therapy improved the KPS scores of the patients （ P〈0.05 ） . Conclusions EMT occurred in the CTC of elderly patients with non-small cell lung cancer and it may promote development of the disease; CIK therapies significantly prevent the process of EMT.