外周血循环肿瘤细胞在不同阶段和不同类型肺癌中的价值研究

The value of peripheral blood circulating tumor cells in different stages and different types of lung cancer

目的探讨外周血循环肿瘤细胞(CTC)在不同阶段、不同类型肺癌中的价值。方法选取148例肺癌患者为肺癌组,79例肺部良性疾病患者为肺部良性疾病组,15例健康者为健康对照组。采用免疫磁珠阴性富集法捕获外周血中CTC;采用流式细胞仪检测免疫荧光染色后的CTC,并分析其与肺癌患者临床特征的关系。结果肺部良性疾病组与健康对照组的CTC检出率比较,差异无统计学意义(P﹥0.05);肺癌组的CTC检出率明显高于肺部良性疾病组和健康对照组(P﹤0.01)。临床分期为Ⅲ~Ⅳ期、M分期为M1期的肺癌患者的CTC检出率分别高于临床分期为Ⅰ~Ⅱ期、M分期为M0期的患者(P﹤0.05),而不同性别、年龄、组织学类型、T分期和N分期的肺癌患者的CTC检出率比较,差异均无统计学意义(P﹥0.05)。结论大部分肺癌中均存在CTC,其检出率与肺癌患者的临床分期及远处转移情况有关,早期检测CTC有利于肺癌患者的病情评估。

Objective To explore the value of peripheral blood circulating tumor cells（CTC） in different stages and different types of lung cancer. Method 148 patients with lung cancer were selected as lung cancer group, 79 patients with benign lung disease were selected as benign lung disease group, and 15 healthy subjects were selected as healthy control group. The CTC in peripheral blood were captured by immunomagnetic beads negative enrichment method and were detected by flow cytometer after immunofluorescence staining. The relationship of CTC with the clinical features was analyzed. Result There was no significant difference between the detection rates of CTC of benign lung disease group and healthy control group（P〉0.05）; the detection rate of CTC in lung cancer group was significantly higher than those in benign lung disease group and healthy control group（P〈0.01）. The CTC detection rate in patients with III-IV clinical stage and M1 of M staging was higher than that in patients with I-II clinical stage and M0 of the M staging（P〈0.05）, but there was no significant difference between different gender, age, histological type and T/N staging（P〉0.05）.Conclusion Most of patients with lung cancer have CTC, and the detection rate is related to the clinical stage and distant metastasis. Early detection of CTC is beneficial to the assessment of the disease.