探讨叶酸受体阳性循环肿瘤细胞在肺癌患者早期诊断与预后评估中的作用

The role of folic acid receptor circulating tumor cells in early diagnosis and prognosis of lung cancer patients

目的探讨叶酸受体阳性循环肿瘤细胞(FR+CTC)在肺癌患者早期诊断与预后评估中的作用.方法分析2020年3月至2020年10月广州医科大学附属第一医院胸外科、呼吸科住院和门诊患者的FR+CTC(CytoploRare®)检测结果对于不同疾病类型的灵敏度,以及和肺癌患者结节大小、病理分期和病理类型的关系.结果FR+CTC水平与性别、年龄无关.良性疾病患者中,FR+CTC的灵敏度为73.9%.初诊患者中,FR+CTC的灵敏度为76.0%.FR+CTC阳性灵敏度对于肺癌早期诊断的临床符合率是75.8%,术后和治疗后患者FR+CTC水平相比初诊患者下降;FR+CTC水平整体和分期有一定的相关性,Ⅰ期患者中FR+CTC的灵敏度为71.5%,适用于肺癌的早期发现.浸润癌与原位癌/微浸润的FR+CTC差异具有统计学意义(P=0.0371);FR+CTC水平与肺结节/肿块大小没有明确的相关性.结论FR+CTC在肺癌患者早期诊断中起重要作用,其与肺癌肿瘤分期、浸润性有相关性,是较好的预后评估指标.

Objective To investigate the role of folic acid receptor circulating tumor cells in early diagnosis and prognosis of lung cancer patients.Methods Folic acid receptor levels in inpatients and outpatients of thoracic surgery/respiratory department of our hospital from March to October 2020 were analyzed,and the relationship between the size of nodules,pathological stages and pathological types was analyzed.Results Among patients with benign diseases,the sensitivity of FR+CTC was 73.9%;among newly diagnosed patients,the detection rate of FR+CTC was 76.0%,and the overall clinical compliance rate was 75.8%.There was a correlation between postoperation/overall and staging of FR+CTC level.The CTC level of stageⅣpatients was significantly higher than that of stageⅠ/Ⅱ/Ⅲpatients(P=0.0371).There were statistically significant differences in FR+CTC between infiltrating carcinoma and in situ carcinoma/microinfiltrating carcinoma.There was no clear correlation between FR+CTC level and pulmonary nodule/mass size.Conclusions FR level plays an important role in the early diagnosis of lung cancer patients,which is correlated with tumor stage and invasion,and is a good prognostic indicator.