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目的 探讨流式细胞仪定量分析外周循环血中癌细胞的临床意义。方法 外周血经Ficoll梯度离心分离单核细胞组分,后者用CD45、细胞角蛋白(CK)及肺癌单克隆抗体(２F7/S5A)染色后,应用流式细胞仪检测 CD45~(CK)~+2F7/S5A~+细胞,计算每升血中上述细胞含量,定量分析143例肺癌,26例良性肺部疾病,20例健康对照外周血中的癌细胞。结果20例健康对照均为阴性,26例良性肺部疾病2例阳性,143例肺癌患者60例阳性,阳性可测率42%,阴性可测率95.7%,检测阳性细胞含量的平均数为 0.722×10~6/L。M_1组阳性率高于M_0组,两且差异有显著意义P=0.000,阳性率与期别正相关,P=0.024。阳性组和阴性组的中位生存期分别为 17.0月及 18.8月,生存率阳性组稍低,但无统计学意义。结论 应用流式细胞仪定量分析肺癌患者外周循环血中CD45~CK~＋2F7/S5A~+细胞反应肺癌患者外周循环血中的微量癌细胞,有助于判断肺癌的转移倾向和预后。
Objective To investigate the clinical significance of quantitative analysis of cancer cells in circulating peripheral blood by flow cytometry. Methods Peripheral blood was separated by Ficoll gradient centrifugation, and the latter was stained with CD45, cytokeratin (CK) and lung cancer monoclonal antibody (2F7/S5A). CD45~(CK) was detected by flow cytometry. +2F7/S5A~+ cells were used to calculate the above cell contents per liter of blood, and 143 lung cancer cases, 26 benign lung diseases, and 20 healthy control peripheral blood cancer cells were quantitatively analyzed. Results Twenty healthy controls were negative, 26 had positive benign lung disease in 2 cases, 143 lung cancer patients in 60 cases were positive, positive detectable rate was 42%, negative detectable rate was 95.7%, and the average number of positive cells detected was 0.722. ×10~6/L. The positive rate of M_1 group was higher than that of M_0 group, and the difference was significant (P=0.000). The positive rate was positively correlated with the period (P=0.024). The median survival time was 17.0 months and 18.8 months in the positive and negative groups, respectively, and the survival rate was slightly lower in the positive group, but it was not statistically significant. Conclusion The application of flow cytometry to quantitatively analyze the peripheral blood of patients with lung cancer in the circulating blood of lung cancer patients with CD45~CK~+2F7/S5A~+ cell reaction is helpful to determine the metastasis tendency and prognosis of lung cancer.