论文部分内容阅读
目的:非小细胞肺癌(non-small cell lung cancer,NSCLC)的发生发展和肿瘤血管新生密切相关,但是目前临床缺乏有效、准确地评估肿瘤血管新生的指标,循环内皮细胞(circulating endothelial cell,CEC)作为血管新生的新型标志物具有无创和重复性好的优势,本研究拟探讨NSCLC患者外周血CEC的临床价值。方法:收集2010年6月~2012年12月南京市胸科医院收治初诊NSCLC患者不同时段的外周血标本,利用多色流式细胞技术检测CEC的数量,并且和临床分期、治疗反应和生存等指标进行比较。结果:正常对照样本、Ⅰ~Ⅱ期以及Ⅲ~Ⅳ期NSCLC患者CEC表达中位数分别为26、86和163个/ml,与对照样本比较差异具有显著性(P值分别为0.001和0.048)。基线CEC>150个/ml的NSCLC患者中位无疾病进展生存期(progression-free survival,PFS)为5.6个月,而基线CEC<150个/ml的NSCLC患者中位PFS为8.8个月,两者差异具有显著性(P=0.026);治疗后(复发)CEC>150个/ml的NSCLC患者中位PFS为4.5个月,而治疗后(复发)CEC<150个/ml的NSCLC患者中位PFS为8.8个月,两者差异具有显著性(P<0.001)。结论:NSCLC患者外周血CEC计数与疾病分期和预后具有相关性,是预测预后和监测微小残留病灶的潜在新指标。
OBJECTIVE: The occurrence and development of non-small cell lung cancer (NSCLC) are closely related to tumor angiogenesis. However, the current clinical lack of effective and accurate assessment of tumor angiogenesis indicators, circulating endothelial cells (CEC ) As a new marker of angiogenesis has the advantage of noninvasive and good reproducibility. This study was to investigate the clinical value of CEC in peripheral blood of patients with NSCLC. Methods: Peripheral blood samples of patients with newly diagnosed NSCLC admitted to Nanjing Chest Hospital from June 2010 to December 2012 were collected. The number of CECs was detected by multi-color flow cytometry and correlated with clinical stage, treatment response and survival The indicators are compared. Results: The median of CEC expression in normal controls, stage Ⅰ ~ Ⅱ and stage Ⅲ ~ Ⅳ NSCLC patients were 26,86 and 163 / ml, respectively, which were significantly different from the control samples (P = 0.001 and 0.048, respectively) . The median progression-free survival (PFS) was 5.6 months in NSCLC patients with baseline CEC> 150 / ml and 8.8 months in NSCLC patients with baseline CEC <150 / ml (P = 0.026); median PFS was 4.5 months in NSCLC patients with CEC> 150 / ml after treatment (relapsed), and median of CEC <150 / ml after treatment PFS was 8.8 months, the difference was significant (P <0.001). Conclusion: CEC count in peripheral blood of NSCLC patients is correlated with the stage and prognosis of the disease. It is a potential new index for predicting prognosis and monitoring minimal residual disease.