【摘要】 目的探讨叶酸受体α(FRα)联合上皮细胞粘附分子(EpCAM)用于非小细胞肺癌(NSCLC)循环肿瘤细胞(CTC)的检测效果,并分析CTC与NSCLC临床病理特征的关系。方法收集2016年9月至2017年1月41例中晚期NSCLC患者全血,并使用免疫磁珠分选法检测CTC,对比EpCAM单独检测组(单独检测组)与EpCAM联合FRα检测组(联合检测组)的CTC检出率,并分析CTC检出率与NSCLC临床病理特征的关系。结果在41例NSCLC患者中,单独检测组的CTC检出率为48. 8%,联合检测组为73. 2%(P=0. 003)。在两个检测组中,CTC检出率与性别、年龄、临床分期、脑转移、骨转移、肾上腺转移和胸腔积液无关(P>0. 05)。在单独检测组中,CTC检出率与病理类型无关(P=0. 269);但在联合检测组中,腺癌的CTC检出率明显高于鳞癌(P=0. 036)。在联合检测组中,CTC检出率与CEA升高有关(P=0. 029),而在单独检测组中两者之间无关(P=0. 087)。CYFRA21-1升高及CA125升高与CTC检出率无关(P>0. 05)。在肺腺癌患者中,CEA升高与FRα阳性的CTC检出率有关(P=0. 027)。结论联合FRα与EpCAM的免疫磁珠分选技术可提高肺腺癌CTC的检出率,CEA升高与FRα阳性的CTC检出率有关。更多还原

【Abstract】 Objective To investigate the effect of folate receptor alpha (FRα) combined with epithelial cell adhesion molecule (EpCAM) on the detection of circulating tumor cells (CTCs) in non-small cell lung cancer (NSCLC),and analyze the relationship between CTCs and clinical features of NSCLC. Methods The peripheral blood of 41 NSCLC patients from September 2016 to January 2017 was enrolled and the CTCs were detected by the method of immunomagnetic bead sorting. The CTCs detective rate was compared between EpCAM group and EpCAM combined with FRα group. The relationship between CTCs detective rate and clinicopathological features of NSCLC was also analyzed. Results The detective rate of CTCs was 48. 8% in EpCAM group,and 73. 2% in EpCAM combined with FRα group in 41 patients of NSCLC (P = 0. 003). In the two groups,the detective rate of CTCs was not related to gender,age,clinical stage,brain metastasis,bone metastasis,adrenal gland metastasis and pleural effusion (P > 0. 05). In EpCAM group,CTCs detective rate was not related to pathological types,but in EpCAM combined with FRα group,it was higher in adenocarcinoma than in squamous cell carcinoma (P = 0. 036). In EpCAM combined with FRα group,CTCs detective rate was related to elevated CEA (P = 0. 029),but in EpCAM group,there was no relationship between CTCs detective rate and CEA level (P = 0. 087). No correlation between CTCs and CYFRA21-1 as well as CA125 was found (P>0. 05). Patients with elevated CEA had higher levels of CTCs for positive FRα in adenocarcinoma (P = 0. 027). Conclusion The detective rate of CTCs can be improved by the combination of FRαand EpCAM in lung adenocarcinoma,and the patients with elevated CEA is correlated to positive FRα expression.更多还原