【摘要】：目的聯(lián)合檢測(cè)肺腺癌患者外周血中細(xì)胞角蛋白(cytokeratin,CK,肺腺癌循環(huán)腫瘤細(xì)胞陽性)和CD133基因(肺癌干細(xì)胞標(biāo)志物)的表達(dá),探討二者在評(píng)估肺腺癌預(yù)后的臨床價(jià)值。方法選取2014年6月至2016年6月昆明總醫(yī)院心胸外科和宣威市第一人民醫(yī)院心胸外科的178例未化療的肺腺癌手術(shù)患者,中位年齡59歲,其中男性78例,女性100例。收集患者術(shù)前外周血標(biāo)本10 m L,細(xì)胞塊法和CK(免疫細(xì)胞化學(xué)法)用于檢測(cè)CTC,PCR法用于檢測(cè)CD133表達(dá)。免疫組化法檢測(cè)肺腺癌組織中CK、Vimentin(Vim)、TTF-1、Ki-67、CD133的表達(dá),并分析與外周血CK和CD133表達(dá)的關(guān)系。根據(jù)外周血CK和CD133的檢測(cè)結(jié)果,將病例分為CK/CD133雙陽性組和非雙陽性組,統(tǒng)計(jì)學(xué)分析兩組間臨床病理因素的差異。結(jié)果 178例肺腺癌患者外周血CTC(CK陽性)的檢出率為48.3%(86/178),與癌組織中Ki-67、Vim表達(dá)顯著正相關(guān)(P0.05);外周血的CD133陽性表達(dá)率為66.9%(119/178),與癌組織Vim、CD133表達(dá)顯著正相關(guān)(P0.05);外周血CK/CD133雙陽組53例(29.8%),雙陽組淋巴結(jié)轉(zhuǎn)移率顯著增高,肺腺癌組織學(xué)分化級(jí)別顯著降低,臨床分期顯著提高,轉(zhuǎn)移率顯著增高(P0.05)。結(jié)論肺腺癌患者外周血中CK與CD133雙陽性表達(dá)提示外周血存在干性特征的循環(huán)腫瘤細(xì)胞,表明預(yù)后不良,聯(lián)合檢測(cè)CK與CD133可用于肺腺癌患者預(yù)后監(jiān)測(cè)和指導(dǎo)治療。
[Abstract]:Objective to detect the expression of cytokeratin CK (positive circulating tumor cells) and CD133 gene (stem cell marker of lung cancer) in peripheral blood of patients with lung adenocarcinoma and to evaluate their clinical value in evaluating the prognosis of lung adenocarcinoma. Methods from June 2014 to June 2016, 178 patients with lung adenocarcinoma were selected from cardiothoracic surgery department of Kunming General Hospital and Cardiothoracic surgery Department of the first people's Hospital of Xuanwei City. The median age was 59 years old, including 78 males and 100 females. The peripheral blood samples of the patients were collected 10 mL before operation, and the expression of CD133 was detected by CT-PCR and CK (immunocytochemical method). Immunohistochemical method was used to detect the expression of CK-Vimentin (Vim) and Ki-67-pCD133 in lung adenocarcinoma, and the relationship between the expression of CK and CD133 in peripheral blood was analyzed. According to the detection results of CK and CD133 in peripheral blood, the patients were divided into CK/CD133 double positive group and non double positive group. The difference of clinicopathological factors between the two groups was analyzed statistically. Results the positive rate of CTC (CK expression in peripheral blood of 178 patients with lung adenocarcinoma was 48.3% (86 / 178), which was positively correlated with Ki-67Vim expression (P0.05), and the positive rate of CD133 expression in peripheral blood was 66.9% (119/ 178), which was significantly correlated with the expression of Vim-CD133 in cancer tissue (P0.05), and in peripheral blood CK/CD133 double positive group (53 cases) (P0.05). The lymph node metastasis rate in the Shuangyang group was significantly higher than that in the control group (29.8%). Histological differentiation grade, clinical stage and metastasis rate of lung adenocarcinoma decreased significantly (P0.05). Conclusion the positive expression of CK and CD133 in peripheral blood of patients with lung adenocarcinoma suggests that there are circulating tumor cells with dry characteristics in peripheral blood, indicating poor prognosis. The combined detection of CK and CD133 can be used to monitor the prognosis of patients with lung adenocarcinoma and to guide the treatment.
【作者單位】： 成都軍區(qū)昆明總醫(yī)院心胸外科;成都軍區(qū)昆明總醫(yī)院病理實(shí)驗(yàn)科;云南省第二人民醫(yī)院急診科;云南省宣威市第一人民醫(yī)院心胸外科;
【基金】：國(guó)家教育部重點(diǎn)實(shí)驗(yàn)室開放課題(2013jszl13) 云南省應(yīng)用基礎(chǔ)青年基金(2013FD091)~~
【分類號(hào)】：R734.2

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