CAJ | 학술논문

目的：探讨肺癌患者循环肿瘤细胞（CTC）与其临床病理特征的关系。方法取65例肺癌（肺癌组）、10例肺良性疾病患者和10例健康志愿者（对照组）外周血7．5mL，应用免疫磁珠阴性富集联合免疫细胞化学染色检测Pan-CK＋/CD45-的CTC，分析CTC与患者临床特征的关系。结果在65例肺癌患者中，CTC阳性率为69．23％（45/65），肺良性疾病患者及健康志愿者均未检出CTC。TNM分期Ⅰ～Ⅱ、Ⅲ、Ⅳ期患者CTC阳性率分别为23．08％（3/13）、50．00％（6/12）、90．00％（36/40），各亚组肺癌患者CTC阳性率差异有统计学意义（P＝0．000）；转移性（M1期）肺癌患者CTC阳性率为83．33％（35/42），较非转移性（M0期）肺癌患者CTC阳性率43．48％（10/23）显著升高（P＝0．002）；随着转移部位个数（0、1、2、3）的增多，CTC阳性率呈升高趋势（43．48％、83．33％、87．50％、75．00％），各亚组肺癌患者CTC阳性率差异有统计学意义（P＝0．024）；CTC阳性率在细胞角质蛋白19片段（Cyfra21-1）＜5．6μmol/L组（53．33％，16/30）与Cyfra21-1≥5．6μmol/L组（82．86％，29/35）间差异有统计学意义（P＝0．021）；在乳酸脱氢酶（LDH）＜270U/L组（55．00％，22/40）与LDH≥270U/L组（92．00％，23/25）间差异也有统计学意义（P＝0．004）。结论部分肺癌患者中存在CTC；CTC阳性率与肺癌患者的临床分期、M分期、发生远处转移部位的个数、Cy-fra21-1值及LDH值密切相关；检测CTC有利于更精确的病情评估。
목적：탐토폐암환자순배종류세포（CTC）여기림상병리특정적관계。방법취65례폐암（폐암조）、10례폐량성질병환자화10례건강지원자（대조조）외주혈7．5mL，응용면역자주음성부집연합면역세포화학염색검측Pan-CK＋/CD45-적CTC，분석CTC여환자림상특정적관계。결과재65례폐암환자중，CTC양성솔위69．23％（45/65），폐량성질병환자급건강지원자균미검출CTC。TNM분기Ⅰ～Ⅱ、Ⅲ、Ⅳ기환자CTC양성솔분별위23．08％（3/13）、50．00％（6/12）、90．00％（36/40），각아조폐암환자CTC양성솔차이유통계학의의（P＝0．000）；전이성（M1기）폐암환자CTC양성솔위83．33％（35/42），교비전이성（M0기）폐암환자CTC양성솔43．48％（10/23）현저승고（P＝0．002）；수착전이부위개수（0、1、2、3）적증다，CTC양성솔정승고추세（43．48％、83．33％、87．50％、75．00％），각아조폐암환자CTC양성솔차이유통계학의의（P＝0．024）；CTC양성솔재세포각질단백19편단（Cyfra21-1）＜5．6μmol/L조（53．33％，16/30）여Cyfra21-1≥5．6μmol/L조（82．86％，29/35）간차이유통계학의의（P＝0．021）；재유산탈경매（LDH）＜270U/L조（55．00％，22/40）여LDH≥270U/L조（92．00％，23/25）간차이야유통계학의의（P＝0．004）。결론부분폐암환자중존재CTC；CTC양성솔여폐암환자적림상분기、M분기、발생원처전이부위적개수、Cy-fra21-1치급LDH치밀절상관；검측CTC유리우경정학적병정평고。
Objective To investigate the relationship between the presence of circulating tumor cells (CTC) and the clinicopatho-logic characteristics of primary lung cancer patients .Methods Samples of peripheral blood(7 .5 mL) from 65 cases of patients with lung cancer(lung cancer group) and 10 cases of patients with lung benign diseases and 10 healthy volunteers (control group) ,and then those CTC were enriched by negative immunomagnetic separation with anti-CD45 antibody and then dectected by immunocyto-chemistry with anti-pan-cytokeratin antibody .The relationship between the positive rate of CTC and clinicopathologic characteristics of lung cancer patients were analyzed .Results The positive rate of CTC in lung cancer patients was 69 .23% (45/65) ,while CTC was not detected in any patients with lung benign disease or healthy volunteers .The positive rate of CTC in patients at TNM stageⅠ - Ⅱ ,Ⅲ and Ⅳ was 23 .08% (3/13) ,50 .00% (6/12) and 90 .00% (36/40) ,respectively .There was significant difference in posi-tive rate of CTC between patients at different TNM stages (P= 0 .000) .The positive rate of CTC in metastatic (stage M1 ) lung cancer patients(83 .33% ,35/42) was significantly higher than that in non-metastatic(stage M0 ) lung cancer patients(43 .48% ,10/23)(P=0 .002) .With the increasing number(0 ,1 ,2 ,3) of metastatic sites ,the positive rate of CTC increased (53 .48% ,83 .33% , 87 .50% ,75 .00% ) ,and there was significant difference in different positive rates of CTC (P=0 .024) .There was statistically sig-nificant difference in the positive rate of CTC between Cyfra 21-1 normal group(53 .33% ,16/30) and high value group(92 .00% ,23/25)(P=0 .021) ,the same with LDH normal group(55 .00% ,22/40) and high value group(82 .86% ,29/35)(P=0 .004) .Conclu-sion CTC were presented in some lung cancer patients .The presence of CTC in peripheral blood is correlated positively with the patients′clinical stage ,M stage ,the number of metastatic sites ,Cyfra21-1 value and LDH value .CTC detection is useful for more accurate risk assessment of patients with lung cancer .