1. 上海中医药大学附属龙华医院肿瘤科,上海,200032
2. 上海市中医药研究院中医肿瘤研究所,上海,200032
3. 中国中医科学院中医内科学博士后流动站,北京,100700
4. 上海中医药大学研究生院,上海,201203
5. 上海中医药大学附属市中医医院肿瘤科,上海,200071
6. 上海交通大学系统生物医学研究院,上海,200240
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田建辉, 罗斌, 毕凌, 等. 非小细胞肺癌循环肿瘤细胞表达规律及其与“伏邪”致病关系的研究[J]. 上海中医药杂志, 2016,50(1):15-19.
TIANJian-hui, LUO Bin, BI Ling, et al. Expression of circulating tumor cells in NSCLC and its relationship with “Hidden Pathogen”[J]. Shanghai Journal of Traditional Chinese Medicine, 2016,50(1):15-19.
目的:明确非小细胞肺癌患者外周血中循环肿瘤细胞(CTC)的表达规律,探讨其与“伏邪”致病的关系。 方法:共纳入69例病例,采用微流控芯片方法捕获并检测外周血中CTC,分析其与临床分期、吸烟状态、病理类型的关系。 结果:①69例患者中,CTC阳性率达97.10%(每2 ml外周血中的 CTC≥1个)。②Ⅰ-Ⅱ期与Ⅲ期、Ⅲ期与Ⅳ期之间CTC计数差异无统计学意义(P,>,0.05);Ⅰ-Ⅱ期与Ⅳ期比较,CTC计数差异有统计学意义(P,<,0.05);Ⅰ-Ⅲa期与Ⅲb-Ⅳ期比较,CTC计数差异有统计学意义(P,<,0.05)。③相关分析结果显示,CTC水平与临床分期(Ⅰ-Ⅲa与Ⅲb-Ⅳ期)呈负相关(r,s,=-0.253,P=0.036),与吸烟状态呈正相关(r,s,=0.475,P,<,0.001),与病理类型(r,s,=0.05,P=0.681)、年龄(r=-0.099,P=0.416)未发现明显相关。 结论:CTC与肺癌临床分期呈负相关,与吸烟状态呈正相关;CTC有望成为非小细胞肺癌术后的疗效预测和预后判断指标;CTC在体内的分布和致病特点具有与中医“伏邪”相似的特性,可为完善肺癌术后患者的中医药治疗策略提供新的思路。
Objective:To analyze the relationship between Circulating Tumor Cells(CTC) and clinical characteristics in patients with NSCLC.Methods69 NSCLC patients who had a definite pathological diagnosis were included,and the CTC was detected by using the method of microfluidic. The correlation analysis was carried out with the clinical stage,smoking status,pathological types and so on; Results①Of the 69 patients,the positive rate of CTC was 97.10% (CTC,>,=1per 2ml blood). ②The CTC count of patients with stage Ⅰ-Ⅱ vs. stage Ⅲ, stage Ⅲ vs stage Ⅳ was not significantly correlated with clinical stage (P,>,0.05). But the CTC count that between stage I-Ⅱ and stage IV was significantly correlated(P,<,0.05),and so was to stage Ⅰ-Ⅲa vs. stage Ⅲb-Ⅳ (P,<,0.05). ③ The results showed that there was negative relationship between CTC levels and clinical stage (stage Ⅰ-Ⅲa and stage Ⅲb-Ⅳ)(r,s,=-0.253,P=0.036), but the number of CTC was obviously correlated with smoking status(r,s,=0.475,P,<,0.001);while the number of CTC was not correlated with the pathological type(r,s,=0.05,P=0.681)and age(r,s,=-0.099,P=0.416) . Conclusion:The NSCLC patients’ CTC count was negatively correlated with clinical stages, and positively correlated with smoking status. The potential use of CTC in the therapeutic evaluation,treatment as well as prognosis of NSCLC is worthy of further studying. The distribution and pathological characters of CTC is similar to that of “Hidden Pathogen”, the finding provided the novel treatment strategy for the early stage NSCLC patients.
非小细胞肺癌循环肿瘤细胞临床分期预后评价伏邪
non-small cell lung cancercirculating tumor cellsclinical stageprognosis evaluationhidden pathogen
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