非小细胞肺癌术后外周血循环肿瘤细胞的检测及其意义

 目的探讨对非小细胞肺癌术后外周血中循环肿瘤细胞(circulatingtumorcells，CTCs)的检测及意义。方法经根治手术治疗并经病理确诊的肺腺癌患者38例，术后TNM分期为Ⅰ期19例，Ⅱ期6例，Ⅲ期13例。10例肺良性病变患者作为对照组，术后病理为肺结核4例，肺部炎性病变6例。采用免疫磁珠富集联合流式细胞术方法检测外周血CTCs(每7.5ml)。结果10例肺良性病变患者术后外周血中CTCs阳性率为10%(1/10)，38例非小细胞肺癌患者术后外周血中CTCs阳性率为39.5%(15/38)。肺良、恶性组CTCs阳性率比较差异无统计学意义(P=0.132)。Ⅰ期与Ⅲ期CTCs阳性率相比差异具有统计学意义(χ²=3.970，P=0.046)。结论非小细胞肺癌术后外周血中存在CTCs，其阳性率与肿瘤TNM分期相关。CTCs检测可用于指导术后治疗。

Significance of detecting circulating tumor cells in peripheral blood of postoperative patients with non-small cell lung cancer

Objective To investigate the significance of detecting circulating tumor cells(CTCs) in peripheral blood of postoperative patients with non-small cell lung cancer(NSCLC). Methods Thirty-eight patients with lung adenocarcinoma diagnosed by pathology and treated by radical surgery, were staged by TNM staging criteria,including stage Ⅰ 19 cases, stage Ⅱ 6 cases, and stage Ⅲ 13 cases. Ten patients with lung benign disease served as control group; they were diagnosed by postoperative pathology(4 cases with tuberculosis, 6 cases with lung inflammatory lesions). CTCs in peripheral blood(every 7.5 ml)were detected by the method of immune magnetic bead-based rare cell enrichment system combined with flow cytometry. Results The positive rate of peripheral blood CTCs was 10%(1/10)in lung benign disease patients and 39.5% (15/38) in NSCLC patients. There was no difference in CTCs positive rate between lung benign disease patients and NSCLC patients(P=0.132).There was difference in CTCs positive rate between Ⅰ stage patients and Ⅲ stage patients(χ²=3.970,P=0.046). Conclusions CTCs can be detected in peripheral blood of postoperative NSCLC patients and can be used to guide the therapy.The positive rate of CTCs is related to TNM staging.