免疫组化法检测NSCLC骨髓微转移的临床研究

Clinical study on the bone marrow micrometastases in patients with non-small cell lung cancer by immunohistochemical techniques

目的 探讨免疫组化检测非小细胞肺癌 (NSCLC)患者骨髓微转移 (BMM )的灵敏度、特异性及临床应用价值。方法 应用免疫组化法检测 6 8例经病理检查证实的NSCLC患者骨髓 (临床分期Ⅰ～Ⅲ期5 3例 ,Ⅳ期 15例 )细胞角蛋白表达 ,诊断肺癌BMM。结果 免疫组化检测BMM的敏感度可达 10 -5水平 ;Ⅰ～Ⅲ期患者BMM阳性率为 2 2 .6 % ( 12 /5 3) ;性别、年龄、卡氏评分、病理类型等因素对BMM阳性率无显著性影响 ;Ⅳ期患者BMM阳性检出率为 5 3.3% ( 8/15 ) ,显著高于Ⅰ～Ⅲ期患者。结论 免疫组化方法检测NSCLC患者的BMM具有较好的敏感性和特异性 。

Objective To investigate the immunohistochemical detected method and the clinical incidence of the bone marrow micrometastases (BMM) in patients with non-small cell lung cancer (NSCLC) and to analyze the sensitivity and specificity and clinical application value. Methods Bone marrow samples were collected from the anterior superior iliac spines or posterior superior iliac spines of 53 patients with NSCLC in clinical stage Ⅰ to Ⅲ and 15 patients in stage Ⅳ, and the BMM was detected by immunohistochemical techniques (IHC) using monoclonal antibodies AE1/AE3 against cytokeratin. χ 2 test was used statistically. Results The IHC sensitivity could be 10 -5. The BMM positive rate was 22.6% (12/53) in stage Ⅰ to Ⅲ and 53.3% (8/15) in stage Ⅳ, and there was a significant difference in the BMM positive rate between stage Ⅰ to Ⅲ and stage Ⅳ (P<0.05). No correlation was observed between BMM and sex, age, KPS, pathology classification and cancer cell differentiation. Conclusion The detection of BMM by IHC is convenient, sensitive, and specific. It might be helpful to diagnose bone marrow micrometastasis in patients with NSCLC.