CAJ | 학술논문

目的：通过观察肿瘤标志物免疫荧光染色-染色体荧光原位杂交技术平台（TM-iFISH）富集并计数肺癌脑膜转移患者脑脊液中的恶性肿瘤细胞，探讨一种新的检测脑脊液中恶性肿瘤细胞的方法。方法选取6例经脑脊液细胞学或头增强MRI扫描确诊的肺癌脑膜转移患者，每例患者经腰椎穿刺获取脑脊液20 mL（共10份），其中7.5 mL应用TM-iFISH技术富集并计数脑脊液中的恶性肿瘤细胞，10 mL行脑脊液细胞学检查，2.5 mL行脑脊液生物化学检查。结果10份脑脊液标本均顺利完成上述检测，其中7份标本通过TM-iFISH技术计数示肿瘤细胞数为3～1823个/7.5 mL脑脊液，3份脑脊液细胞学检查发现肿瘤细胞，9份脑脊液生物化学检查结果蛋白量高于正常值。3例患者治疗后应用TM-iFISH技术再次计数脑脊液恶性肿瘤细胞，2例患者计数较治疗前减少。结论 TM-iFISH技术可以富集并计数肺癌脑膜转移患者脑脊液中恶性肿瘤细胞，可能成为肺癌脑膜转移的诊断和疗效评价方法。
목적：통과관찰종류표지물면역형광염색-염색체형광원위잡교기술평태（TM-iFISH）부집병계수폐암뇌막전이환자뇌척액중적악성종류세포，탐토일충신적검측뇌척액중악성종류세포적방법。방법선취6례경뇌척액세포학혹두증강MRI소묘학진적폐암뇌막전이환자，매례환자경요추천자획취뇌척액20 mL（공10빈），기중7.5 mL응용TM-iFISH기술부집병계수뇌척액중적악성종류세포，10 mL행뇌척액세포학검사，2.5 mL행뇌척액생물화학검사。결과10빈뇌척액표본균순리완성상술검측，기중7빈표본통과TM-iFISH기술계수시종류세포수위3～1823개/7.5 mL뇌척액，3빈뇌척액세포학검사발현종류세포，9빈뇌척액생물화학검사결과단백량고우정상치。3례환자치료후응용TM-iFISH기술재차계수뇌척액악성종류세포，2례환자계수교치료전감소。결론 TM-iFISH기술가이부집병계수폐암뇌막전이환자뇌척액중악성종류세포，가능성위폐암뇌막전이적진단화료효평개방법。
Objective To assess the value of tumor marker immunostaining-FISH (TM-iFISH) technology on concen?trating and enumeration of tumor cells in CSF of lung cancer patients with leptomeningeal metastasis(LM). Methods Six cases of non-small cell lung cancer with leptomeningeal metastasis, which were diagnosed by CSF cytology or enhanced MRI scan, were selected. A total of 20 mL of CSF was collected in each case. TM-iFISH technology was employed to concen?trate and quantify circulating tumor cells in 7.5 mL CSF samples in each case while CSF cytology used 10 mL CSF samples in each case;Finally, the rest 2.5 mL CSF in each case was used for biochemistry assay. Results Ten CSF samples from 6 patients with non-small lung cancer with LM were assayed and tumor cells numbers ranging between 3 and 1 823 every 7.5 mL were found in 7 samples. On the other hand, CSF cytology examination only revealed tumor cells in 3 cases. Using CSF biochemical assay, higher than normal of protein level was found in 9 cases. TM-iFISH technology was employed again in 3 cases of patients who received treatment. Tumor cell count in CSF reduced in 2 out of the 3 cases. Conclusion TM-iFISH technology is a new method for detection and enumeration of tumor cells in the CSF in non-small cell lung cancer patients with leptomeningeal metastasis. This technology present diagnosis and curative values in lung cancer patients with leptomen?ingeal metastasis.