| Medical dissemination is a dilemma for the diagnosis and therapy of the malignant rumors. Because of the technique limitations in the early days, nobody can detect the tumor cells in blood steadily, the mechanism of medical dissemination remained unknown for a long time . As long as the outcoming of the new techniques such as: nested reverse transcriptase polymerase chain reaction (RT-PCR) and immunomagnetic separation(IMS) of cells, we can now actively detect the dissemination of the tumor cells during the medical intervention on patients with malignant diseases. In order to find the rule of tumor cells' dissemination, We've detected the blood samples taken from patients with non-small cell lung cancer(NSCLC) during the operations. Besides this, we separated and cultured the tumor cells from the blood samples to find the activities of the cells released from the primary neoplasm.Firstly, we assayed for the transcripts of carcinoembryonic antigen messenger ribonucleic acid by nested RT-PCR in blood samples taken from 52 patients with NSCLC at four time spots during the operation (T\: beginning of the operation, peripheral vein; T2: ligating the pulmonary vein, peripheral vein; T^. ligating the pulmonary vein, pulmonary vein; 74: 1 hour after T2, peripheral vein ) to find the dissemination rule of the tumor cells. Secondly, we separated the tumor cells in blood samples by IMS and cultured it carefully, activities of the tumor cells has been tested to confirm their ability to form a successful metastasis. We've got the result as follow:1. Separately, the positivity rate of all four time spots are: T] 30.8 %(16/52), T2 53.8^(28/52), T3 53.8%(28/52), T4 53.8%(28/52). The data we've got from Kodak Electrophoresis Analysis System could be used in parameter test after annalysis of normality and homogeneity. The CEA-mRNA level of TI is lower than other time spots, T3 is much higher than other time spots, no difference has been found between TT and T4. 16 samples are positive at TI, other 12 patients turn to positive after T2. Of these 28 positive samples, 14 are taken from patients with squamous carcinama and the rest are adenocarcinoma, no positivity rate difference has been found between them. The positivity rate of CEA-mRNA in samples taken from patients with central lung cancer is higher than patients with peripheral lung cancer, similar phenomenon has been found between patients with late and earlier TNM stage. No control samples are positive for CEA-mRNA, sensitivity of our test is 10~6.2. we've got tumor cells in five blood samples by IMS, only one sample's tumor cells remained alive after cell culture. Morphological analysis and cytokeratin immunochemical analysis confirmed that the malignant cell we've got is of epithelial origin, its double time is 28h and has been stay alive for more than 2 months, the ability of growth and clony forming efficiency is lower than A549~an adenocarcinoma cell line from human.Conclusion:1. More than 50% patients with lung cancer have or have an obvious increase of tumor cells released into circulation during theoperation, the CEA-mRNA level of TS is much higher than other time spots, so, the time of pulmonary vein ligation (later or earlier) may affect the quantity of tumor cells releasing into circulation.2. Patients with lung cancer of central kind have more tumor cells released into circulation than peripheral kind during the operation, it means that the operation may increase the release of tumor cells. To avoid this, the manipulation should be more gentle and the operating time must be as short as possible. As for patients with late TNM stage, accessory therapy such as radiotherapy and chemotherapy should be used to improve the prognosis besides the protection during the operation because they have got more possibility of medical dissemination.3. Our successful separation and culture of tumor cells from blood samples taken gives perfect evidence for tumor dissemination during the operation. More active means...
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