基于免疫磁性纳米球快速高效准确检测淋巴结转移癌细胞

摘要

发展了一种基于免疫磁性纳米球(IMNs)快速、高效、准确检测淋巴结转移癌细胞(LNMCCs)的策略.首先利用本课题组发展的方法制备了具有磁性和生物靶向双功能的IMNs,然后利用IMNs通过免疫磁分选对淋巴结转移癌病人淋巴结穿刺物中的LNMCCs进行分离和富集,最后采用瑞氏染色法和免疫细胞化学(ICC)对富集的LNMCCs进行鉴定,实现对LNMCCs的快速高效准确检测.免疫磁分选实现了LNMCCs的分离和富集,可以有效降低淋巴结穿刺物中的背景干扰;瑞氏染色法和ICC鉴定为准确诊断提供了更多可靠依据,因此,传统细胞学敏感性、特异性和诊断准确率不高的问题得到明显改善.其次,淋巴结穿刺物与IMNs的孵育只需5 min,简便快速,完整保留了LNMCCs的形态学特征,为淋巴结转移癌(LNMC)的分类和后续病理学分析提供了重要基础.此外,IMNs对淋巴结穿刺物中上皮来源癌细胞的特异性捕获可以确诊捕获的细胞为LNMCCs,实现了LNMC和恶性淋巴瘤的鉴别诊断.最后,采用本方法检测了110例病人淋巴结穿刺物中的LNMCCs,总诊断准确率高达98.2%,特异性为100.0%,敏感性为98.0%,相比于传统细胞学诊断都有明显的提高.因此,IMNs用于LNMC病人淋巴结穿刺物中LNMCCs的检测是一次新的尝试,为LNMC的诊断和研究提供了新思路.%A strategy based on immunomagnetic nanospheres ( IMNs ) for rapid, efficient and accurate detection of lymphnode metastasis carcinoma cells ( LNMCCs ) was developed in this study. First, IMNs processing magnetism and biological targeting were fabricated by the approach developed by our group previously. Then, LNMCCs in lymph node fine needle aspiration ( LNFNA) specimens were separated and enriched by the immunomagnetic isolation using IMNs. At last, the captured cells were identified with Wright's staining and immunocytochemistry ( ICC) . The separation and enrichment of LNMCCs with immunomagnetic isolation could reduce the background interference of LNFNA specimens effectively; the identification with Wright ' s staining and ICC offered more reliable information for accurate diagnosis, so the sensitivity, specificity and overall diagnostic accuracy had an obvious improvement compared with the conventional cytologic diagnosis. Besides, the simple and rapid incubation of LNFNA specimens with IMNs needed just 5 min, so the cytomorphology of captured LNMCCs could be intactly retained, which enabled to provide important basis for classifying lymphnode metastasis carcinoma ( LNMC ) and the subsequent pathological study. Moreover, the specific capture of epithelial carcinoma cells in LNFNA specimens with IMNs could make a definite diagnosis of the captured cells as LNMCCs, thus realizing the differentiated diagnosis of LNMC and malignant lymphoma. Additionally, this strategy exhibited successful LNMCCs detection in LNFNA specimens from 110 patients and had higher sensitivity ( 98 . 0%) , specificity ( 100 . 0%) , and overall diagnostic accuracy (98. 2%) than the conventional cytologic diagnosis. Therefore, it was a new attempt to use IMNs for detection of LNMCCs in LNFNA specimens from LNMC patients, and offered new ideas for LNMC diagnosis and study.