非小细胞肺癌中循环肿瘤细胞与Ki-67的相关性

Correlation between circulating tumor cells and Ki-67 in non-small cell lung cancer

目的探讨非小细胞肺癌(NSCLC)中循环肿瘤细胞(CTCs)与Ki-67表达以及临床病理参数之间的关系。方法首先采用Can Patrol^(TM) CTC富集技术分离血液中的CTCs,然后采用免疫组化技术分析手术标本中Ki-67的表达,最后分析CTCs与Ki-67之间的相关性。结果在75例NSCLC患者中,CTCs平均阳性率为92.0%。Ⅰ期(n=26)、Ⅱ期(n=21)、Ⅲ期(n=22)、Ⅳ期(n=6)组的间质型CTCs阳性率分别为30.1%、42.9%、50.0%和66.7%,Ⅲ+Ⅳ期间质型CTCs阳性率较Ⅰ+Ⅱ期明显高,差异有统计学意义(X^2=4.265、P=0.039)。间质型CTCs阳性率在有淋巴结转移与无淋巴结转移中比较,差异有统计学意义(X^2=4.904、P=0.027),表明间质型CTCs阳性率随着NSCLC进展而增加。不同性别、年龄、病理类型、分化程度的Ki-67高表达率与间质型CTCs阳性率比较差异无统计学意义(P>0.05)。Ki-67高表达组的间质型CTCs阳性率为55.1%(27/49),高于Ki-67低表达组的30.8%(8/26),两组差异具有统计学意义(X^2=4.041、P=0.044)。结论随着肺癌临床分期越晚,间质型CTCs阳性率越高,Ki-67表达量与间质型CTCs阳性率密切相关,对肿瘤的发展、转移及预后评估有着重要意义。

Objective To investigate the correlation between circulating tumor cell （CTCs） and Ki -67 expres- sion or clinicopathological parameters in non - small cell lung cancer （NSCLC）. Methods The CTCs in blood was sepa- rated by CanPatrolTMCTC enrichment technique. The expression of Ki - 67 in surgical specimens was analyzed by immu- nohistochemistry. The correlation between CTCs and Ki -67 was analyzed. Results The positive rate of CTCs in 75 patients with NSCLC was 92%. The positive rate of interstitial CTCs were 30. 1%, 42. 9%, 50. 0% and 66. 7% in Stage Ⅰ （n =26）, Stage Ⅱ （n =21）, Stage Ⅲ （n =22） and Stage 1V （n =6） NSCLC, respectively. At Stage Ⅲ and IV, the positive rate of CTCs was significantly higher than that at Stage Ⅰ and Ⅱ （χ^2 = 4. 265, P = 0. 039）. The positive rate of CTCs was significantly different between those with lymph node metastasis and without lymph node metastasis （χ^2 = 4. 904, P = 0. 027）. The positive rate of interstitial CTCs was increased with the progression of NSCLC. There was no sig- nificant difference in Ki -67 index or interstitial CTCs positive rate among genders, ages, pathologic types or differentia- tions （P 〉 0. 05 ）. The positive rate of interstitial CTCs in Ki - 67 high expression group was 55.1% （27/49）, which was significantly higher than that in Ki -67 low expression group （30. 8%, 8/26） （χ^2=4. 041, P =0. 044）. Conclusion In CTCs, the positive rate of interstitial CTCs increases with progression of NSCLC, and the Ki - 67 expression is closely correlated to the positive rate of interstitial CTCs.