循环肿瘤细胞数目与血清中Cyfra21-1、CEA、Fg表达水平的关系

The relationship between circulating tumor cells counting and Cyfra 21-1,CEA,Fg

目的:探讨肿瘤患者外周血循环肿瘤细胞(CTCs)与常用的肿瘤指标细胞角质素19可溶片段(Cyfra21-1)、癌胚抗原(CEA)及凝血功能指标纤维蛋白原(Fg)表达水平的关系,比较CTCs阳性组和阴性组转移灶数目差异。方法:采集66例进展期晚期肺癌住院患者治疗前7.5ml外周血,保存于4℃冰箱中,24小时内由益善生物技术公司使用"免疫去除结合纳米过滤法"行CTCs检测。同时检测血清中Cyfra21-1、CEA、Fg水平,收集并分析CTCs数目与转移灶数目、临床T分期、转移淋巴结的关系。结果:纳入患者中CTCs检出率为86.4%。CTCs数目与Cyfra21-1水平有相关关系,相关系数为0.365(P=0.003);CTCs数目与Fg水平相关,相关系数为0.330(P=0.007);CEA与CTCs两变量无明显相关性。两组患者的肿瘤转移器官数目大于3个的比例有显著差异。结论:两组患者Cyfra21-1异常增高率有显著差异,且CTCs数目与Cyfra21-1表达水平正相关,可由Cyfra21-1初步估计CTCs水平。而外周血中Fg异常增高率无显著差异,但二者表达水平呈明显正相关,因此分析CTCs数目需要考虑Fg表达水平的影响。

Objective：To investigate the relevance between circulating tumor cells （CTCs） counting and the fol- lowing tumor markers ： Cyfra21 - 1, CEA, Fg, and compare the survival, sites of metastasis organs among patients strati- fied by CTCs counting. Methods ： We selected 66 histologically diagnosed advanced lung cancer patients of progres- sion period, applied CanpotrolTM, which developed by SurExam biotechnology company to detect CTCs in the blood, 7.5ml blood was needed before treatment for CTCs test. All the samples were stored at 4 cent degree after col- lection, and samples were tested within 24h. Serum concentration of Cyfra21 - 1, CEA, Fg were detected to investigate the correlation of CTCs counting and tumor markers. Results： Significant correlation was observed between CTCs and serum Cyfra21- 1/Fg,nonparametric correlation analysis using spearman＇s test showed correlation coefficient be- tween CTCs and Cyfra21 - 1 was 0.365 （P = 0.003 ）, and for CTCs and Fg, the correlation coefficient was 0. 330, P = 0. 007. Conclusion ： CTCs of advanced lung cancer patients isolated by immunomagnetical beads and nanofihration based approaches have showed statistically significant correlation with serum concentration of Cyfra21 - 1 and Fg. However,we cannot replace Cyfra21 -1 with CTCs,since negative and positive CTCs groups did not exhibite statisti- cally different abnormality rate for Cyfra21 - 1. When concerning the clincal value of CTCs counting,we suggest taking Fg level into account.