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目的:探讨局部晚期非小细胞肺癌(NSCLC)患者放化疗前后循环肿瘤细胞(circulating tumor cells,CTCS)的变化及其临床意义。方法:选择2016-3月到2017-3月绵阳市中心医院病检确诊NSCLC患者,分期III-IV期,总共50例入组,健康对照组10例。采集肺癌患者放化疗前后及健康对照者外周血,利用免疫磁珠富集联合免疫荧光检测循环肿瘤细胞。对比放化疗前后的动态变化,并分析循环肿瘤细胞与临床特征及疗效关系。结果:循环肿瘤细胞与肺癌诊断相关,肺癌组CTC阳性率56%,健康对照组CTC阳性率0%(P〈0.05),同步放化疗开始前1天,CTCS阳性率56%,2周阳性率为56%,4周为40%,6周30%。在同步放化疗治疗过程中,CTSs阳性率呈逐渐下降趋势。同步放化疗后疗效评估,PR 38例,SD 6例,PD 6例。治疗后达PR+SD的患者在治疗前CTC阳性率为52.3%,治疗后阳性率为25%。PD患者阳性率治疗前83.3%:治疗后66.7%。随着病情的缓解,CTC阳性率逐渐下降。结论:循环肿瘤细胞与肺癌的诊断相关,并且对肿瘤疗效评价有一定意义。
Objective: To investigate the changes of circulating tumor cells (CTCS) in patients with locally advanced non-small cell lung cancer (NSCLC) before and after chemoradiotherapy and its clinical significance. Methods: Patients with NSCLC diagnosed by pathological examination in Mianyang Central Hospital from March 2016 to March 2017 were selected and staged in stage III-IV. A total of 50 cases were enrolled and 10 cases were selected as healthy control group. Peripheral blood of patients with lung cancer before and after radiotherapy and chemotherapy and healthy controls were collected, and circulating tumor cells were detected by immunomagnetic enrichment and immunofluorescence. Compare the dynamic changes before and after radiotherapy and chemotherapy, and analyze the relationship between circulating tumor cells and clinical features and efficacy. Results: The circulating tumor cells correlated with the diagnosis of lung cancer. The positive rate of CTC in lung cancer group was 56% and that of healthy control group was 0% (P <0.05). The positive rate of CTCS was 56% and the positive rate of 2 weeks 56%, 4 weeks 40%, 6 weeks 30%. During concurrent chemoradiotherapy, the positive rate of CTSs showed a gradual downward trend. The efficacy of concurrent chemoradiotherapy, PR 38 cases, SD 6 cases, PD 6 cases. Patients with PR + SD after treatment had a positive CTC positive rate of 52.3% before treatment and a positive rate of 25% after treatment. The positive rate of PD patients was 83.3% before treatment: 66.7% after treatment. With the alleviation of the disease, the positive rate of CTC gradually decreased. CONCLUSION: Circulating tumor cells are associated with the diagnosis of lung cancer and have certain significance for the evaluation of tumor efficacy.