目的初步探讨重组病毒特异性检测肺癌患者外周血活性循环肿瘤细胞（CTC）的临床意义。
方法纳入首都医科大学附属北京安贞医院呼吸与危重症医学科2017年6月至2018年8月住院且经影像及病理学检查确诊的肺癌患者63例（肺癌组），其中腺癌38例，鳞癌13例，小细胞癌12例；男36例，女27例，平均年龄（65±11）岁；纳入同期本科室住院的21例良性肺疾病患者（良性肺疾病组），男11例，女10例，平均年龄（57±13）岁；本院健康体检者18名（健康对照组），男10名，女8名，平均年龄（32±10）岁。应用含重组病毒的CTC体外检测试剂盒检测肺癌组外周血中活性CTC数，并与另外2组进行比较。采用Fisher精确检验比较CTC阳性检出率的组间差异。
结果肺癌组56例活性CTC阳性；良性肺疾病组4例活性CTC阳性，健康组未检出；该检测方法的敏感度为89%（56/63），特异度为90%（35/39）。肺癌组腺癌患者中CTC阳性率为84%（32/38），鳞癌为92%（12/13），小细胞癌12例均阳性；肺腺癌和鳞癌患者活性CTC阳性分布：Ⅰ期2例均阳性，Ⅱ期8例中6例阳性，Ⅲ期8例中7例阳性，Ⅳ期33例中29例阳性。肺癌组不同病理分型、不同临床分期患者CTC阳性率比较差异无统计学意义（χ 2=1.881和3.419，均 P>0.05）。
结论重组病毒特异性检测肺癌患者外周血中活性CTC的方法简便、无创，且敏感度和特异度较高。
ObjectiveTo investigate the clinical significance of recombinant virus-specific detection for detecting viable circulating tumor cell (CTC) in lung cancer patients.
MethodsFrom June 2017 to August 2018, 63 lung cancer patients diagnosed by imaging and pathology at the Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital were recruited for this study, including 38 cases of adenocarcinoma, 13 squamous cell carcinoma, and 12 small cell carcinoma. The patients consisted of 36 males and 27 females, with an average age of (65±11) years. In addition,21 patients with benign lung diseases were recruited for benign lung disease group, including 11 males and 10 females with an average age of (57±13) years. Another 18 healthy subjects were recruited for the healthy control group, including 10 males and 8 females, with an average age of (32±10) years. The peripheral blood viable CTCs were detected by a CTC in vitro detection kit containing recombinant virus. Fisher′s exact test was used to compare the differences between the groups of viable CTC positive rates.
ResultsCases with positive viable CTC in the lung cancer group, the benign lung disease group and the healthy control group were 56,4 and 0, respectively. The sensitivity and specificity of this CTC detection system were 89% (56/63) and 90% (35/39) , respectively. The positive rate of CTC detection for lung cancer patients with adenocarcinoma, aquamous cell carcinoma, and small cell carcinoma, were 84%(32/38), 92% (12/13) and 100% (12/12), respectively. The positive cases from adenocarcinoma and squamous cell carcinoma patients with different stages were 2 ( n=2) in stageⅠ,6 ( n=8) in stage Ⅱ,7( n=8) in stage Ⅲ and 29( n=33) in stage Ⅳ. There were no significant differences in the positive rates of CTC among different histological types or different stages (χ 2=1.881, 3.419; P>0.05) .
ConclusionThis CTC detection system was found to be a simple and non-invasive method for auxiliary diagnosis of lung cancer, with high sensitivity and specificity.
肖瑶,刘双,王增智,等. 重组病毒特异性检测肺癌患者外周血活性循环肿瘤细胞的临床意义[J]. 中华结核和呼吸杂志,2019,42(2)：101-105.
DOI:10.3760/cma.j.issn.1001-0939.2019.02.005版权归中华医学会所有。
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