Li Guolei, Wang Yun, Tan Guoliang, Liu Yuan, Xu Zhao, Feng Hao, Xing Wei, Xu Zhifeng
The First Surgery Department, Hebei Provincial Hospital of Chinese Medicine, Shijiazhuang 050051, China.
Department of Medical Ultrasonics, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.
Zhongguo Fei Ai Za Zhi. 2020 May 20;23(5):351-359. doi: 10.3779/j.issn.1009-3419.2020.103.05. Epub 2020 Apr 27.
Circulating tumor cells (CTC) play an important role in the screening and prognosis of lung cancer, but the low efficiency and specificity of CTC isolation obviously restrict its clinical application. The purpose of this study is to explore a new and efficient isolation method of CTC in patients with non-small cell lung cancer (NSCLC) in order to achieve the purpose of early diagnosis of NSCLC.
Three kinds of immunolipid magnetic spheres of epidermal growth factor receptor (EGFR), vimentin and folic acid (FA) were prepared by thin film method. After characterization, the sorting scheme of cell line was explored, the optimal sorting scheme of NSCLC CTC was constructed, and its clinical application value was studied.
The average capture efficiency of EGFR, Vimentin and FA magnetic spheres used alone and in combination to lung cancer cell lines was 78%, 79%, 82% and 91%, respectively. In 60 patients with lung cancer, using 2 CTC per 7.5 mL blood as cutoff value, the positive rates of EGFR, Vimentin and FA magnets used alone and in combination were 65.0%, 33.3%, 93.3% and 100%, respectively. It was also found that the number of CTC detected by combined use of the three magnetic spheres was correlated with clinical stages (P<0.05).
The combination of three kinds of magnetic spheres can separate EGFR+, Vimentin+, FA+ expressed CTC, which is beneficial to the downstream analysis of CTC correlation. This study provides a new method to improve the efficiency of NSCLC CTC capture, and verifies that the captured CTC counting method can be used in the auxiliary diagnosis of lung cancer.
循环肿瘤细胞(CTC)在肺癌的筛查和预后中发挥着重要作用,但CTC分离的低效率和特异性明显限制了其临床应用。本研究的目的是探索一种新的、高效的非小细胞肺癌(NSCLC)患者CTC分离方法,以实现NSCLC早期诊断的目的。
采用薄膜法制备表皮生长因子受体(EGFR)、波形蛋白和叶酸(FA)三种免疫脂质磁球。经表征后,探索细胞系分选方案,构建NSCLC CTC的最佳分选方案,并研究其临床应用价值。
单独及联合使用EGFR、波形蛋白和FA磁球对肺癌细胞系的平均捕获效率分别为78%、79%、82%和91%。在60例肺癌患者中,以每7.5 mL血液中2个CTC为临界值,单独及联合使用EGFR、波形蛋白和FA磁体的阳性率分别为65.0%、33.3%、93.3%和100%。还发现三种磁球联合使用检测到的CTC数量与临床分期相关(P<0.05)。
三种磁球联合可分离出表达EGFR+、波形蛋白+、FA+的CTC,有利于CTC相关性的下游分析。本研究提供了一种提高NSCLC CTC捕获效率的新方法,并验证了捕获的CTC计数方法可用于肺癌的辅助诊断。