Ⅰ期非小细胞肺癌的分子预后

目的联合检测Ⅰ期非小细胞肺癌（NSCLC）的细胞增殖,凋亡和血管生成,探讨Ⅰ期非小细胞肺癌预后分层。方法应用免疫组织化学方法检测118例Ⅰ期非小细胞肺癌,30例肺良性组织和30例正常肺组织血管内皮生长因子（VEGF）的表达,应用Ki67标记检测细胞增殖指数（PI）。TUNEL法检测70例Ⅰ期非小细胞肺癌,30例正常肺组织凋亡指数（AI）。结果单因素分析结果表明,肿瘤血管浸润、VEGF高表达、高PI、低AI为Ⅰ期非小细胞肺癌的不良预后因素。多因素分析结果显示,肿瘤血管浸润（BVI）、VEGF及PI可以作为影响Ⅰ期非小细胞肺癌预后的独立因素。根据免疫组化综合评分（IRS）IRS=VEGF＋PI＋AI,将患者分为低危组及高危组,5年总体生存率分别为82.22%,23.33%,有显著性差异（P=0.0056）。综合评分可作为独立预后因素（RR=4.878,95%CI：1.379～17.258,P=0.014）。结论联合检测肿瘤的细胞增殖,凋亡和血管生成,可能实现对Ⅰ期非小细胞肺癌的预后分层,判断预后以及指导治疗。     

肺癌患者胸水中肿瘤标志物检测的临床意义

[目的]探讨肺癌患者胸水中肿瘤标志物的检测在临床上的应用价值。[方法]应用酶联免疫吸附实验（ELISA）检测170例肺癌患者和58例肺部良性疾病患者胸水中神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体（pro-GRP）、细胞角蛋白19（CYFRA21-1）、鳞癌抗原（SCC）、p53抗体和CA199的水平含量。[结果]肺癌患者胸水的6种肿瘤标志物水平均明显高于肺部良性疾病组,差异有统计学意义（P〈0.01）。NSE、pro-GRP在小细胞肺癌中的水平明显高于其他类型的肺癌（P〈0.01）;CYFRA21-1、鳞癌抗原（SCC）在鳞癌中的水平明显高于其他类型的肺癌（P〈0.01）。[结论]胸水中6种肿瘤标志物对于肺癌的辅助诊断有一定的临床意义。     

恶性胸膜间皮瘤术后预后因素分析

目的:分析恶性胸膜间皮瘤(MPM)的临床病理特征、生存时间及手术方式并探讨影响术后生存的因素.方法:回顾性总结我院1998-2005 年手术治疗的MPM患者51例,分析胸膜外全肺切除和胸膜切除两种不同手术方式和不同分期对预后的影响,对性别、年龄、手术方式、病理分型和分期等多个预后因素进行探讨.结果:总中位生存期为22个月,1、3和5年生存率分别为68.1%、25.2%和14.5%.胸膜外全肺切除术38例,胸膜切除术13例,不同手术方式之间术后生存期差异无统计学意义.不同TNM分期之间1、3和5年生存率差异有统计学意义,P=0.004.多因素分析结果显示,原发瘤侵袭程度(T)不是影响预后的因素,上皮型肿瘤(P=0.019)、临床分期(P=0.016)和淋巴结转移(N)情况(P=0.002),尤其是N2组淋巴结是影响预后的独立因素.结论:胸膜外全肺切除及胸膜切除两种手术方式对预后的影响差异无显著性,早期肿瘤预后较好;淋巴结转移,尤其是纵隔淋巴结转移是影响预后的的主要因素.早期诊断和尽早手术治疗是取得良好效果的关键.     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.     

I期非小细胞肺癌的分子预后

目的 联合检测I期非小细胞肺癌（NSCLC）的细胞增殖、凋亡和血管生成，探讨I期非小细胞肺癌预后分层。方法应用免疫组织化学方法检测118例I期非小细胞肺癌、30例肺良性组织和30例正常肺组织血管内皮生长因子（VEGF）的表达，应用比Ki67标记检测细胞增殖指数（PI）。TUNEL法检测70例I期非小细胞肺癌，30例正常肺组织凋亡指数（AI）。结果单因素分析结果表明，肿瘤血管浸润、VEGF高表达、高PI、低AI为I期非小细胞肺癌的不良预后因素。多因素分析结果显示，肿瘤血管浸润（BVI、VEGF及PI可以作为影响I期非小细胞肺癌预后的独立因素。根据免疫组化综合评分（IRS）IRS=VEGF＋PI＋AI，将患者分为低危组及高危组，5年总体生存率分别为82．22％、23．33％，有显著性差异（P=0．0056）。综合评分可作为独立预后因素（RR=4．878，95％CI：1．379～17．258，P=O．014）。结论联合检测肿瘤的细胞增殖、凋亡和血管生成，可能实现对I期非小细胞肺癌的预后分层，判断预后以及指导治疗。     

血清肿瘤标志物在肺癌辅助诊断中的应用

背景与目的近年来，肺癌肿瘤标志物的研究不断取得进展，并逐步应用到临床上，本研究探讨6种血清肿瘤标志物在肺癌辅助诊断中的应用价值，并选择最理想的血清肿瘤标志物组合。方法应用酶联免疫吸附实验（ELISA）检测170例肺癌患者、80例健康人和80例肺部良性疾病患者血清中神经元特异性烯醇化酶（NSE）、胃泌素释放肽前体（pro-GRP）、细胞角蛋白19（CYFRA21—1）、鳞癌抗原（SCC）、p53抗体和癌抗原199（CA199）的含量。结果肺癌患者的6种血清肿瘤标志物水平均明显高于健康人组和肺部良性疾病组，差异均有统计学意义（P〈0.01）。NSE、pro—GRP在小细胞肺癌中的水平明显高于其他类型的肺癌（P〈0．01）；CYFRA21-1、鳞癌抗原（SCC）在鳞癌中的水平明显高于其他类型的肺癌（P〈0．01）。NSE、pro—GRP对小细胞肺癌检测的敏感性明显高于其他类型的肺癌（P〈0．01）；CYFRA21—1、鳞癌抗原（SCC）对鳞癌检测的敏感性明显高于其他类型的肺癌（P〈O．01）。6种血清肿瘤标志物经组合后，敏感性明显高于任一单项肿瘤标志物（P〈0．01）。结论6种血清肿瘤标志物对于肺癌的辅助诊断有一定的临床意义。NSE、pro-GRP二者可作为联合检测小细胞肺癌的标志物组合；CYFRA21—1、SCC可作为联合检测肺鳞癌的标志物组合。     

非小细胞肺癌循环肿瘤细胞的定量检测意义

目的 探讨定量检测非小细胞肺癌病人肺静脉和外周静脉血循环肿瘤细胞与临床分期、治疗及预后监测的相关性.方法 选择25例非小细胞肺癌病人,10例良性肺疾病者(对照组)、健康志愿者10位.经CD326免疫磁珠阳性分选富集循环肿瘤细胞(CTCs)标本后,行CK-FITC、CD45PE荧光抗体标记,应用多参数流式细胞仪对CTCs进行定量检测.结果 25例非小细胞肺癌病人术中肺静脉血CTCs定量检测阳性率为64%(16/25例),明显高于外周静脉血CTCs阳性率40%(10/25例)的水平(P<0.05);Ⅰ期13例中外周血CTCs阳性3例(23.0%),肺静脉血CTCs阳性8例(61.5%).结论 非小细胞肺癌CTCs水平的定量检测是较为敏感的肿瘤进展、治疗反应和预后预测的评价指标;免疫磁珠富集联合流式细胞分析技术检测CTCs的敏感性和特异性较高,具有一定的临床应用前景.     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.     

非小细胞肺癌循环肿瘤细胞的定量检测意义

Objective To investigate the sensitivity, specificity and clinical significance of detecting circulating tomor cells (CTCs) in NSCLC. Methods Twenty-five patients who undetwent surgical resection for NSCLC form Jan 2007 to Apr 2007 were in- cluded in this study. Control group included 10 patients with benign pulmonary diseses (2 case of hamartoma and 8 case of pulmonary tu berculosis) and 10 healthy volunteers. The pulmonary veins blood and peripheral vein blood were collected respectively. The CD326 immunomagnetic beads and CK-fluorescein isothiocyanate (CK-FITC) were served as the marker antibodies of CTCs. Firstly mononu- clear cell marked by minibeads conjugated with CD326, the mononuclear cells were enriched and separated though Magnetic-activated cell separation(MACS), then the positive separtion cells were marked by anti-CK-FTTC and anti-leukocyte antibody CD45-phyco- erythrine (anti-CD45-PE), finally those cells detected and analyzed by flow cytometry . Results For stage Ⅰ and stage Ⅱ patients (n= 16), CTCs were detected from peripheral vein blood of in 5 (5/16, 31.25%) and from pulmonary veins blood in 9 (9/16, 56.25%). For stage Ⅲ and stage Ⅳ, CTCs were detected from peripheral vein blood in 5 (5/9, 55.56%) and from pulmonary veins blood in 9(7/9,77.78%).For stage Ⅰ,CTCs were detected from peripheral vein blood in 3(3/13,23%)and from pulmo- nery veins blood in 8(8/13,61.54%).The whole CTCs positive detection rate from pilmonary veins blood was 64%(16/25)which higher than feom peripheral vein blood(40%,10/25)(P<0.05).Conclusion The method was set up by MACS combined with FCM to detect the CTCs of pulmonary veins blood and peripheral vein blood of patients.with NSCLC,MACS combined with FCM may improve detection rate of CTCs.This technique appears to be an efficient to detect circulating tumor cells and may be important for dinical practice in the future.