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[目的]分析可手术性非小细胞肺癌 (NSCLC)患者术前和术中癌细胞血道播散及其对患者预后的影响。[方法]术前或术中采集外周血或肺静脉血 ,应用流式细胞仪进行癌细胞定量测定。患者于手术后定期随访 ,并与检测结果作统计学分析。[结果]对44例NSCLC患者血样进行了检测 ,共发现16例存在癌细胞 ,阳性率为36.4 % ,癌细胞平均含量为0.286×106/L。其中60岁以下年龄组的癌细胞阳性率显著高于60岁以上年龄组(P<0.05) ,鳞癌患者的癌细胞含量显著高于腺癌患者 (P<0.05)。但25%的腺癌患者在术前已出现癌细胞播散 ,术中阳性率为42.9%,癌细胞阳性率与病期无明显相关性 ;鳞癌患者术前未发现阳性病例 ,术中阳性率为57.1% ,阳性者以Ⅲ、Ⅳ期为主。随访结果显示 ,血循环癌细胞阳性和阴性组的中位生存期分别为15个月和>30个月 ,2年生存率分别为31.3%和71.4 % ,具有统计学显著差异 (P<0.05)。[结论]肺癌患者在手术前或手术过程中可发现血液中存在癌细胞 ,此类患者的预后差、生存期短。
[Objective] To analyze the influence of preoperative and intraoperative hematogenous spread of cancer cells on the prognosis of patients with operable non-small cell lung cancer (NSCLC). [Method] Peripheral blood or pulmonary venous blood was collected preoperatively or intraoperatively, and the quantitative determination of cancer cells was performed by flow cytometry. Patients were followed up regularly after surgery and statistically analyzed with the test results. [Results] The blood samples from 44 patients with NSCLC were detected. Among the 16 samples, there were 16 cancer cells, the positive rate was 36.4% and the average content of cancer cells was 0.286 × 106 / L. The positive rate of cancer cells in the age group of 60 years old was significantly higher than that of the age group of 60 years old (P <0.05). The content of cancer cells in squamous cell carcinoma was significantly higher than that in adenocarcinoma (P <0.05). However, 25% of patients with adenocarcinoma have been preoperative dissemination of cancer cells, the positive rate was 42.9%, the positive rate of cancer cells and the stage had no significant correlation; squamous cell carcinoma patients had no positive cases before surgery, positive The rate was 57.1%, positive were Ⅲ, Ⅳ-based. The follow-up results showed that the median survival time of positive and negative group was 15 months and> 30 months, respectively. The 2-year survival rates were 31.3% and 71.4% respectively, with statistical significance (P <0.05). [Conclusion] The patients with lung cancer can find the presence of cancer cells in the blood before or during the surgery. Such patients have poor prognosis and short survival.