循环肿瘤细胞分型检测在非小细胞肺癌中的应用

目的 探讨非小细胞肺癌患者外周血中循环肿瘤细胞(circulating tumor cells,CTCs)的数量和型别分布,分析其与临床病理特征之间的关系.方法 采用最新CanPatrolTM CTCs分型检测技术,基于滤膜法收集221例非小细胞肺癌患者外周血中的CTCs,通过RNA原位杂交、分支DNA技术对循环肿瘤细胞内的上皮、间质标志物mRNA进行荧光检测,将CTCs分成上皮型、混合型、间质型,分析其与年龄、性别、临床病理分期和是否远处转移的关系.结果 90.05％非小细胞肺癌患者检出CTCs,3个型别里混合型CTCs检出比例最高.总CTCs,上皮型、混合型、间质型CTCs数量与临床分期和远处转移有关(P＜0.05),与年龄和性别无关(P＞0.05).Logistic回归分析结果显示,间质型CTCs是临床分期和远处转移的危险因素.结论 在外周血循环肿瘤细胞检测中,数量和分型均有重要价值,其中间质型CTCs可能为非小细胞肺癌患者肿瘤分期及远处转移提供重要线索.

Typing of circulating tumor cells for non-small cell lung cancer

Objective To investigate the number and distribution of circulating tumor cells (CTCs) in peripheral blood of non-small cell lung cancer(NSCLC) patients,and analyze their correlation with clinical pathological features.Methods The CanPatrolTMCTCs enrichment technique was used to isolate and classify CTCs from the peripheral blood samples of 221 NSCLC patients.RNA in situ hybridization and branched DNA technology were employed to detect the epithelial and mesenchymal markers of CTCs at mRNA level by fluorescence detection.Based on the results,there were 3 phenotypes identified,that is,epithelial CTCs,biophenotypic (epithelial/mesenchymal) CTCs,and mesenchymal CTCs.And the number and type were analyzed for the correlation with sex,age,clinical stage and distant metastasis.Results CTCs were detected in 90.05％ of NSCLC patients,and of the 3 types,the biophenotypic CTCs took the first rank.The numbers of total CTCs,epithelial CTCs,biophenotypic CTCs,and mesenchymal CTCs were associated with clinical stage and distant metastasis (P ＜ 0.05),but were irrelevant with sex and age (P ＞ 0.05).Logistic regression analysis showed that mesenchymal type of CTCs was a risk factor for clinical stage and distant metastasis.Conclusion Both number and phenotype are important in the detection of CTCs.Mesenchymal CTCs may offer valuable insights for tumor staging and metastatic evaluation in the NSCLC patients.