Typing Of Circulating Tumor Cells(CTCs) And Associated Analysis With Non-small Cell Lung Cancer

Objective:Count the number and analyze the type distribution of the circulating tumor cells?CTCs?in peripheral blood from sufferers of non-small-cell lung cancer?NSCLC?,to explore the epithelial-mesenchymal transition?EMT?state,and to investigate which role three different types of CTCs play in early diagnosis of non-small-cell lung cancer,estimate of tumor node metastasis?TNM?stages,and forecast of tumor distant metastasis.Method:CTCs were collected from the peripheral blood of 221 sufferers of non-small-cell lung cancer,62 sufferers of benign lung diseases and 21 healthy volunteers based on filter membrane method.Can Patrol^TMCTCs typing detection technique was conducted,including fluoroscopic examination of m RNA markers for epithelium and mesenchyme fromcirculating tumor cells treated by mRNA in-situ hybridization and branched DNA signal amplification technology.The CTCs were divided into epithelial type,mixed type and mesenchyme type,which were further analyzed correlations with age,gender,TNM staging,and distant metastasis.Finally,the discriminatory analysis was adopted to determinewhether the detected samples were from healthy volunteers,sufferers of benign lung diseases or non-small-cell lung cancer according to CTCs number and types.Besides,to estimatewhether sufferers of non-small-cell lung cancer had distant metastasis was carried out as well.Result:1.The positive proportion of mesenchyme type CTCs and quantity median in non-small-cell lung cancer of?stage were 82.56%and 3,respectively,which were significantly higher than 36.30%and 0 for non-small-cell lung cancer of?^?stage,28.82%and 0 for benign lung diseases,and 14.29%and 0 for the healthy population,respectively?P?0.05?.2.The epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs were utilized to diagnose whether the distant metastasis occurred insufferers of non-small-cell lung cancer,with a specificity of 84%?95%CI:77.57%⁹0.43%?and a sensitivity of 82.89%?95%CI:74.42%⁹1.35%?.Amongthe test samples,7 of 10 sufferers of NSCLC with non-distant metastasis were correctly determined,and 7 of 10 sufferers of NSCLC with distant metastasis were also correctly determined.3.Different typesof CTCs,including epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs were used to differentiate the healthy from the sufferers of non-small-cell lung cancer,with a specificity of 73.33%?95%CI:50.95%⁹5.71%?and a sensitivity of 63.98%?95%CI:57.5%⁷0.46%?.Likewise,the epithelial type CTCs and mesenchyme type CTCs wereused to differentiate the sufferers of benign lung diseases from thoseof non-small-cell lung cancer,with a specificity of 53.85%?95%CI:40.3%⁶7.4%?and a sensitivity of 70.62%?95%CI:64.47%⁷6.77%?.Amongthe test samples,4 of 5 healthy persons were correctly determined,4 of 10 sufferers of benign lung disease were correctly determined,and 7 of 10 sufferers of non-small-cell lung cancer were correctly determined.4.90.05%of sufferers of non-small-cell lung cancer were detected to have CTCs,with the highest proportion of mixed type CTCs.The quantity of total CTCs,epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs was uncorrelated withage or gender?P?0.05?.5.The moresevere TNM staging,the positive rateof epithelial type CTCs gradually decreased,while the positive rate ofmesenchyme type CTCs increased gradually on the contrary?P?0.01?.Result of logistic regression analysis showed that the epithelial type CTCs and mesenchyme type CTCs are the risk factors for clinical staging and distant metastasis.Conclusions:1.Can Patrol^TMCTCs typing detection technique can successfully detect the epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs in peripheral blood of NSCLC sufferers.2.The epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs can all be detected from the peripheral blood of NSCLC sufferers of different characteristics,and are uncorrelated with gender orage of sufferers.3.The epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs have huge potential in monitoring whether distant metastasis occurs in NSCLC sufferers,,with a specificity and sensitivity both over than80%.4.The epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs have powerful potential in screening and early diagnosis of NSCLC,with a fine specificity and sensitivity both.5.The epithelial type CTCs,mixed type CTCs and mesenchyme type CTCs,especially the mesenchyme type CTCs,have strong correlation with TNM staging and distant metastasis of NSCLC sufferers.