CAJ | 학술논문

目的流式细胞技术检测非小细胞肺癌骨髓微转移，研究其与病理学因素及术后转移率的关系，探讨非小细胞肋骨骨髓微转移临床检测的价值。方法选取2004年3月至2007年5月手术治疗的患者非小细胞肺癌病例158例，术中抽取肋骨骨髓，应用流式细胞技术，检测骨髓中阳性细胞表达率。结果 158例非小细胞肺癌患者59例出现骨髓微转移，阳性率37.34％( 59/158)。59例骨髓微转移阳性患者术后18例(30.51％)肺癌患者出现远处转移；99例骨髓微转移阴性患者中术后14例(14.14％)出现远处转移。骨髓微转移与非小细胞肺癌肿瘤大小和临床分期相关，与患者年龄、性别、病理类型和分化程度无关。肿瘤体积越大，骨髓微转移阳性率增高；分期增高，骨髓转移阳性率也增高。骨髓微转移阳性患者比阴性患者有较高的转移率。结论非小细胞肺癌可以发生早期骨髓微转移，骨髓微转移与临床病理指标有关。流式细胞术检测骨髓微转移可作为临床监测、指导辅助治疗和判断预后的参考指标。
목적 류식세포기술검측비소세포폐암골수미전이，연구기여병이학인소급술후전이솔적관계，탐토비소세포륵골골수미전이림상검측적개치。방법 선취2004년3월지2007년5월수술치료적환자비소세포폐암병례158례，술중추취륵골골수，응용류식세포기술，검측골수중양성세포표체솔。결과 158례비소세포폐암환자59례출현골수미전이，양성솔37.34％( 59/158)。59례골수미전이양성환자술후18례(30.51％)폐암환자출현원처전이；99례골수미전이음성환자중술후14례(14.14％)출현원처전이。골수미전이여비소세포폐암종류대소화림상분기상관，여환자년령、성별、병리류형화분화정도무관。종류체적월대，골수미전이양성솔증고；분기증고，골수전이양성솔야증고。골수미전이양성환자비음성환자유교고적전이솔。결론 비소세포폐암가이발생조기골수미전이，골수미전이여림상병리지표유관。류식세포술검측골수미전이가작위림상감측、지도보조치료화판단예후적삼고지표。
Objective To evaluate the detection value of rib bone marrow micrometastasis ( BMM ) in patients with non-small lung cancer ( NSCLC ) by using flow cytometry ( FCM ) and determine the relationship between BMM and clinicopathological parameters. Methods 158 patients undergoing surgical treatment for NSCLC during April 2004 to May 2007 were prospectively analyzed. Bone marrow aspirates were obtained intraoperatively and the expression rate of the postive cells was determined by using flow cytometry. Results 59of the 158 ( 37.34 ％ ) patients occurred, 18 ( 30.51％ ) of whom developed distant metastases. 14 of the 99 ( 13.9％ ) patients without BMM developed distant metastases.BMM was correlated with tumor size and tumor stage, but not with age, sex, pathological types, differentiation degrees. The bigger the tumor size and the higher the tumor stage, the higher the frequency of BMM.Patients with BMM had a higher metastatic rate than in those without BMM ( P ＜ 0.05 ). Conclusions Non-small lung cancer can occur early bone marrow micrometastasis. BMM is correlated with some clinic pathological parameters. Detection of BMM by flow cytometry can be used as an indicator for instruction of treatment and prediction of prognosis.