循环肿瘤细胞联合血清学检测在非小细胞肺癌中的应用

doi:10.6040/j.issn.1671-7554.0.2024.0763

摘要/Abstract

摘要： 目的探究循环肿瘤细胞(circulating tumor cells, CTCs)联合肺癌自身抗体及肿瘤标志物检测在非小细胞肺癌(non-small cell lung cancer, NSCLC)中的应用。方法采集161例NSCLC患者、19例肺良性病变患者及20例健康志愿者静脉血,通过免疫磁珠阴性富集法对CTCs进行检测,分析其与NSCLC临床资料的相关性,并与肺癌自身抗体及肿瘤标志物诊断效能进行比较。结果患者的性别、吸烟史、肿瘤部位及淋巴结转移情况所对应的CTCs计数差异均无统计学意义(P>0.05)。年龄、T分期、肿瘤最大直径、肿瘤分期、病理类型所对应的CTCs计数差异有统计学意义(P<0.05)。NSCLC患者外周血叶酸受体阳性CTCs以8.9 FU/3 mL为最佳截断值,诊断的灵敏度和特异度分别为84.5%、76.9%,ROC曲线下面积为0.801。CTCs与肺癌自身抗体和肿瘤标志物联合检测能够提高NSCLC的诊断效能。三项联合检测的ROC曲线下面积为0.914,95%CI为86.8~96.1(P<0.001)。结论 CTCs、肺癌自身抗体、肿瘤标志物检测对于临床上NSCLC的诊断及筛查可提供一定的参考价值,三项联合可以提高诊断NSCLC的临床意义。

关键词: 循环肿瘤细胞, 非小细胞肺癌, 自身免疫抗体, 肿瘤标志物, 早期诊断

Abstract: Objective To explore the application of circulating tumor cells(CTCs)combined with detection of lung cancer autoantibodies and tumor markers in non-small cell lung cancer(NSCLC). Methods The venous blood of 161 patients with NSCLC, 19 patients with benign lung lesions and 20 healthy volunteers were collected, and CTCs were detected by negative enrichment method of immunomagnetic beads. The correlation between CTCs and clinical data of NSCLC was analyzed, and the diagnostic efficiency of CTCs, autoantibodies and tumor markers of lung cancer were compared. Results There were no significant differences of CTCs counts in gender, smoking history, tumor site and lymph node metastasis(all P>0.05). There were significant differences of CTCs counts in age, T stage, maximum tumor diameter, tumor stage and pathological type(all P<0.05). The optimal cutoff value of folic acid receptor positive CTCs in peripheral blood of NSCLC patients was 8.9 FU/3mL. The sensitivity and specificity of diagnosis were 84.5% and 76.9%, respectively, and the area under ROC curve was 0.801. Combined detection of CTCs, lung cancer autoantibodies and tumor markers could improve the diagnostic efficiency of NSCLC. The area under ROC curve of the three combined tests was 0.914, and the 95%CI was 86.8-96.1(P<0.001). Conclusion The detection of CTCs, lung cancer autoantibodies and tumor markers can provide some reference for the diagnosis and screening of NSCLC in clinic, and the combination of the three items can improve the clinical significance of the diagnosis of NSCLC.

Key words: Circulating tumor cells, Non-small cell lung cancer, Autoantibodies, Tumor biomarkers, Early diagnosis

中图分类号:

R604

赵汉卿,周新睿,李子建,唐兴. 循环肿瘤细胞联合血清学检测在非小细胞肺癌中的应用[J]. 山东大学学报 (医学版), 2025, 63(5): 79-85.

ZHAO Hanqing, ZHOU Xinrui, LI Zijian, TANG Xing. Application of circulating tumor cells combined with serological detection in non-small cell lung cancer[J]. Journal of Shandong University (Health Sciences), 2025, 63(5): 79-85.

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