目的：探讨肿瘤患者外周血循环肿瘤细胞（CTCs）与常用的肿瘤指标细胞角质素19可溶片段（Cy-fra21－1）、癌胚抗原（CEA）及凝血功能指标纤维蛋白原（Fg）表达水平的关系，比较 CTCs 阳性组和阴性组转移灶数目差异。方法：采集66例进展期晚期肺癌住院患者治疗前7．5ml 外周血，保存于4℃冰箱中，24小时内由益善生物技术公司使用“免疫去除结合纳米过滤法”行 CTCs 检测。同时检测血清中 Cyfra21－1、CEA、Fg水平，收集并分析 CTCs 数目与转移灶数目、临床 T 分期、转移淋巴结的关系。结果：纳入患者中 CTCs 检出率为86．4％。CTCs 数目与 Cyfra21－1水平有相关关系，相关系数为0．365（P ＝0．003）；CTCs 数目与 Fg 水平相关，相关系数为0．330（P ＝0．007）；CEA 与 CTCs 两变量无明显相关性。两组患者的肿瘤转移器官数目大于3个的比例有显著差异。结论：两组患者 Cyfra21－1异常增高率有显著差异，且 CTCs 数目与 Cyfra21－1表达水平正相关，可由 Cyfra21－1初步估计 CTCs 水平。而外周血中 Fg 异常增高率无显著差异，但二者表达水平呈明显正相关，因此分析 CTCs 数目需要考虑 Fg 表达水平的影响。%Objective:To investigate the relevance between circulating tumor cells(CTCs)counting and the fol-lowing tumor markers:Cyfra21 -1,CEA,Fg,and compare the survival,sites of metastasis organs among patients strati-fied by CTCs counting.Methods:We selected 66 histologically diagnosed advanced lung cancer patients of progression period,applied CanpotrolTM,which developed by SurExam biotechnology company to detect CTCs in the blood,7. 5ml blood was needed before treatment for CTCs test.All the samples were stored at 4 cent degree after collection,and samples were tested within 24h.Serum concentration of Cyfra21 -1,CEA,Fg were detected to investigate the correla-tion of CTCs counting and tumor markers.Results:Significant correlation was observed between CTCs and serum Cy-fra21 -1 /Fg,nonparametric correlation analysis using spearman's test showed correlation coefficient between CTCs and Cyfra21 -1 was 0.365 (P =0.003),and for CTCs and Fg,the correlation coefficient was 0.330,P =0.007. Conclusion:CTCs of advanced lung cancer patients isolated by immunomagnetical beads and nanofiltration based ap-proaches have showed statistically significant correlation with serum concentration of Cyfra21 -1 and Fg.However,we cannot replace Cyfra21 -1 with CTCs,since negative and positive CTCs groups did not exhibite statistically different abnormality rate for Cyfra21 -1.When concerning the clincal value of CTCs counting,we suggest taking Fg level into account.
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