目的探讨利用免疫磁珠富集技术联合巢式RT-PCR。方法检测非小细胞肺癌患者(NSCLC)手术前后外周血微转移的预后价值。方法应用免疫磁珠联合巢式LUNX-mRNA RT-PCR检测80例NSCLC 患者手术前后外周血微转移，研究其与临床和病理特征的相关性和预后价值。结果手术前和手术后，LUNX表达阳性率分别为41例（51.3%）和28例（35.0%）；手术前LUNX表达阳性率与病理分期有关。手术后LUNX表达阳性率与病理分期、病理类型、体重减轻和KPS评分有关。手术前LUNX表达阳性和阴性患者的4年生存率分别为26.8%和35.9%；手术后LUNX表达阳性和阴性患者的4年生存率分别为17.8%和38.5%；多因素分析显示，手术后LUNX表达阳性是一独立不良预后因素。结论免疫磁珠富集技术联合巢式RT-PCR方法是检测NSCLC患者外周血微转移的敏感方法，手术后检测微转移有预后价值；微转移阴性患者比阳性患者预后好%Objective To investigate the clinical significance of detecting micrometastasis in preoperative and postoperative peripheral blood of NSCLC patients by immunomagnetic beads and nested PCR. Methods Peripheral blood was taken from 80 NSCLC patients before and after operation. LUNX-mRNA of the peripheral blood was detected by immunomagnetic beads and nested PCR and both their relationship with clinicopathological features and prognostic significance were further investigated. Results The positive rates of LUNX-mRNA were 51.3% and 35.0%, respectively, before and after operation. The positive rates of LUNX-mRNA before operation were closely in correlation with TNM stage. In contrast, it turned out to be more closely related with histological types, weight loss, KPS status as wel as TNM stage after operation. The 4-yr overal survival rate for preoperative LUNX-positive and -negative patients were 26.8% and 35.9%, respectively, while for postoperative LUNX-positive and -negative patients were 17.8%and 38.5%, respectively. Multivariate analysis showed that the postoperative LUNX-positive was an independent unfavorable prognostic factor. Conclusion Immunomagnetic beads and nested PCR were a sensitive method to detect micrometastasis in peripheral blood of NSCLC patients. Detection of micrometastasis in postoperative peripheral blood may possess a prognostic significance. Micrometastasis-negative patients have better prognosis compared to those with micrometastasis -positive patients.
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