循环肿瘤细胞在肺癌诊断中的应用及临床意义

为了探讨循环肿瘤细胞(circulating tumor cells,CTCs)在肺癌诊断中的应用及临床意义,本研究收集了我院2014年10月至2017年12月收治并确诊的肺癌患者87例、健康体检者40名以及肺部良性疾病患者50例作为研究对象,采用人循环肿瘤细胞试剂盒测定外周血CTC水平,两组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis检验,利用ROC曲线评价CTC在肺癌诊断上的灵敏度以及特异度。实验发现肺癌患者CTC水平(M=12.67 Unints/3 mL)显著高于肺部良性病患者(M=4.76 Unints/3 mL)和健康者(M=4.48 Unints/3 mL),差异存在统计学意义(p<0.001)。在不同性别、不同年龄段以及不同病理类型之间肺癌患者的CTC水平比较差异无统计学意义(p>0.05)。Ⅲ+Ⅳ期肺癌患者CTC水平显著高于Ⅰ+Ⅱ期患者,差异存在统计学意义(p<0.001)。有远处转移的肺癌患者CTC水平显著高于无远处转移的肺癌患者,差异存在统计学意义(p<0.001)。ROC曲线下面积为0.878(95%CI 0.820~0.936),临界值为6.34 Unints/3 mL,对应的灵敏度为0.77,特异度为0.989。本研究初步认为,CTC检测对肺癌诊断具有较高的灵敏度以及特异度,可能存在重要的临床应用价值。

Application and Clinical Significance of Circulating Tumor Cells in the Diagnosis of Lung Cancer

To explore the application and clinical significance of circulating tumor cells(CTCs)in diagnosis of lung cancer,from October 2014 to December 2017,87 lung cancer patients admitted and diagnosed,40 healthy subjects and 50 patients with benign lung diseases were collected from our hospital.Peripheral blood CTC levels were measured with human circulating tumor cell assay kit.The differences between two groups or among three groups were analyzed by Mann-Whitney U test or Kruskal-Wallis test respectively.The sensitivity and specificity of CTC in lung cancer diagnosis were evaluated by ROC curve.The CTC levels of patients with lung cancer(M=12.67 Unints/3 mL)was significantly higher than that of patients with benign lung disease(M=4.76 Unints/3 mL)and healthy patients(M=4.48 Unints/3 mL)(p<0.001).There was no statistically significant difference in CTC levels between different genders,different age groups and different pathological types in lung cancer patients(p>0.05).The CTC levels of lung cancer patients atⅢ+Ⅳstage was significantly higher than that of patients atⅠ+Ⅱstage(p<0.001).The CTC levels of lung cancer patients with distant metastasis was significantly higher than that of lung cancer patients without distant metastasis(p<0.001).The area under the ROC curve was 0.878(95%CI 0.820~0.936)with a critical value of 6.34 Unints/3 mL and the corresponding sensitivity was 0.77 and specificity was 0.989.The preliminary conclusion of this study was that CTC has high sensitivity and specificity for lung cancer diagnosis,which may have important clinical application value.