CAJ | 학술논문

目的：研究小细胞肺癌（ SCLC ）患者不同分期外周血循环肿瘤细胞（ CTC ）的表达情况，探讨其在肺癌转移早期诊断中的意义。方法病例对照研究。选取2011年4月至2013年4月在上海长海医院住院治疗的SCLC患者35例（局限期12例，广泛期23例）和非结核肺良性疾病患者25例。采集静脉血7.5 ml放入CellSave管中，样品经过处理后经CellTracks AutoPrep 系统荧光扫描后，系统根据荧光结果判读，对CTC进行计数。分析比较SCLC和良性肺疾病患者外周血CTC表达的差异，分析比较临床广泛期和局限期SCLC患者CTC表达的差异。同时，采集2 ml静脉血，离心后取上清液进行NSE （神经元特异性烯醇化酶）检测。研究CTC 与NSE的相关性。相关分析采用Sperman′s rank法。结果 SCLC患者外周血CTC表达显著高于良性疾病对照组[ CTC≥1阳性率分别为80.0％和12.0％（χ2＝27.003，P＜0.0001），CTC≥5的阳性率分别为51.4％和0（χ2＝18.367， P＜0.0001），CTC≥10阳性率分别为34.3％和0（χ2＝10.714，P＜0.001），CTC≥50阳性率分别为17.1％和0（P＝0.036，P＜0.05）]。广泛期SCLC的CTC阳性率显著高于局限期[CTC≥1阳性率分别为58.3％和91.3％（P＝0.033，P＜0.05）， CTC≥5的阳性率分别为65.2％和25.0％（P＝0.035， P＜0.05）]。 SCLC患者外周血CTC数量与血清NSE水平呈明显正相关（r＝0.7437，P＜0.0001）。结论 SCLC患者CTC的表达显著高于良性对照组，且与临床分期密切相关，CTC的表达对于早期预测SCLC的转移和恶化具有一定的指导意义。
목적：연구소세포폐암（ SCLC ）환자불동분기외주혈순배종류세포（ CTC ）적표체정황，탐토기재폐암전이조기진단중적의의。방법병례대조연구。선취2011년4월지2013년4월재상해장해의원주원치료적SCLC환자35례（국한기12례，엄범기23례）화비결핵폐량성질병환자25례。채집정맥혈7.5 ml방입CellSave관중，양품경과처리후경CellTracks AutoPrep 계통형광소묘후，계통근거형광결과판독，대CTC진행계수。분석비교SCLC화량성폐질병환자외주혈CTC표체적차이，분석비교림상엄범기화국한기SCLC환자CTC표체적차이。동시，채집2 ml정맥혈，리심후취상청액진행NSE （신경원특이성희순화매）검측。연구CTC 여NSE적상관성。상관분석채용Sperman′s rank법。결과 SCLC환자외주혈CTC표체현저고우량성질병대조조[ CTC≥1양성솔분별위80.0％화12.0％（χ2＝27.003，P＜0.0001），CTC≥5적양성솔분별위51.4％화0（χ2＝18.367， P＜0.0001），CTC≥10양성솔분별위34.3％화0（χ2＝10.714，P＜0.001），CTC≥50양성솔분별위17.1％화0（P＝0.036，P＜0.05）]。엄범기SCLC적CTC양성솔현저고우국한기[CTC≥1양성솔분별위58.3％화91.3％（P＝0.033，P＜0.05）， CTC≥5적양성솔분별위65.2％화25.0％（P＝0.035， P＜0.05）]。 SCLC환자외주혈CTC수량여혈청NSE수평정명현정상관（r＝0.7437，P＜0.0001）。결론 SCLC환자CTC적표체현저고우량성대조조，차여림상분기밀절상관，CTC적표체대우조기예측SCLC적전이화악화구유일정적지도의의。
Objective To investigate the expression of Circulating tumor cells ( CTCs ) in peripheral blood cells of patients with different stages of Small-Cell Lung Cancer ( SCLC) ,and to evaluate its significance in early diagnosis of lung cancer metastasis.Methods Thirty-five patients with SCLC ( 12 in limited stage and 23 in extensive stage ) and 25 patients with benign lung disease were recruited at the Shanghai Changhai Hospital from April 2011 to April 2013.Samples were prepared from 7.5 ml peripheral venous blood and collected in CellSave tubes.The CTC counts were determined using CellTracks AutoPrep fluorescence scanning system according to the manufacturers′instructions.The expression of CTCs in peripheral blood of SCLC patients and benign lung disease patients were analyzed.The expression of CTCs in different stages of SCLC was measured and compared.Furthermore, samples were prepared from 2 ml peripheral venous blood by centrifugation.The serum levels of NSE Neuron specific enolase were measured.The relationship between the expression of CTC and NSE was analyzed.Results CTCs positive rates in SCLC were significantly higher than in benign lung disease controls [ Positive rates of CTC≥1 were 80.0%and 12.0%(χ2 =27.003,P<0.000 1),CTC≥5 were 51.4%and 0 (χ2 =18.367,P<0.000 1), CTC≥10 were 34.3%and 0(χ2 =10.714,P<0.001),CTC≥50 were 17.1 and 0(P=0.036,P<0.05), respectively ].CTCs positive rates in SCLC extensive stage were significantly higher than limited-stage [Positive rates of CTC≥1 were 58.3% and 91.3%(P=0.033,P<0.05), CTC≥5 were 65.2% and 25.0%(P=0.035,P<0.05), respectively].The expression of CTCs was significantly correlated with NSE (r=0.743 7, P<0.000 1).Conclusion The expression of CTC in SCLC patients is significantly higher than those in control group , and is closely related to clinical stages , which may provide new clues to early predicting of SCLC metastasis and deterioration.