循环肿瘤细胞在肺肿瘤患者诊疗中的应用价值

Application value of circulating tumor cells in the diagnosis and treatment of lung tumor patients

目的分析循环肿瘤细胞(CTC)在肺肿瘤患者诊疗中的临床应用价值。方法选取郑州大学第一附属医院胸外科2020年4月至2022年4月收治的14例肺良性肿瘤患者和40例肺恶性肿瘤患者,通过配体靶向聚合酶链反应(PCR)法检测患者术前、术后1个月的CTC水平,分析外周血CTC水平与临床资料之间的关系,并对以上患者进行跟踪随访。应用χ^(2)检验、Willcoxon秩和检验和Cox回归进行数据分析。结果肺恶性肿瘤患者组CTC阳性率高于肺良性肿瘤患者组[75.0%(30/40)比35.7%(5/14),χ^(2)=7.018,P<0.05]。CTC阳性表达率与性别、年龄、组织学类型无明显相关(χ^(2)=0.320、2.133、0.076,P>0.05),而与肿瘤病理分期(χ^(2)=3.372,P<0.001)及肿瘤最大径(χ^(2)=3.843,P<0.001)明显相关。CTC阳性是肺癌患者术后转移复发的危险因素[风险比(HR):0.145,95%置信区间:0.031~0.685,P<0.05]。结论肺癌患者的CTC水平与肿瘤TNM分期相关,有利于判断肺结节的性质,有助于肺肿瘤诊断,有助于预后评估及术后指导治疗。

Objective To analyze the clinical application value of circulating tumor cells(CTCs)in the diagnosis and treatment of lung tumor patients.Methods A total of 14 patients with benign lung tumors and 40 patients with malignant lung tumors admitted to the thoracic surgery department of our hospital from April 2020 to April 2022 were selected.The CTCs levels of patients before and one month after surgery were detected using ligand targeted polymerase chain reaction(PCR).The relationship between peripheral blood CTCs levels and clinical data was analyzed,and the patients were followed up.Data were analyzed using chi-square test,Wilcoxon rank sum test,and Cox regression.Results The positive rate of CTCs in patients with malignant lung tumors was significantly higher than that in patients with benign lung tumors[75.0%(30/40)vs.35.7%(5/14),χ^(2)=7.018,P<0.05].The positive expression rate of CTCs was not significantly correlated with gender,age and histological type(χ^(2)=0.320,2.133,0.076,P>0.05),but with tumor pathological stage(χ^(2)=3.372,P<0.001)and maximum diameter(χ^(2)=3.843,P<0.001).Positive CTC was a risk factor for postoperative metastasis and recurrence in lung cancer patients[hazard ratio(HR):0.145,95%confidence interval(CI):0.031-0.685,P<0.05].Conclusion The level of CTCs in lung cancer patients is correlated with tumor TNM staging,which is beneficial for determining the nature of lung nodules,aiding in the diagnosis of lung tumors,prognosis evaluation,and postoperative guidance for treatment.