一种提高脑膜转移癌诊断率的新技术

    A Noval Technology of Improving the Diagnostic Rate in Leptomeningeal Metastasis

    • 摘要: 目的 使用CellSearch系统和循环肿瘤细胞检测试剂盒(上皮来源)检测并计数疑似肺癌脑膜转移患者脑脊液中的恶性肿瘤细胞,探讨该技术检测脑脊液中恶性肿瘤细胞的可行性。 方法 研究对象为20例症状明显的疑似肺癌脑膜转移患者和1例无脑膜转移的肺癌患者。每例患者收集首次经腰椎穿刺脑脊液10~15 mL,其中5~7.5 mL应用CellSearch系统检测脑脊液中的恶性肿瘤细胞数量,5~7.5 mL进行脑脊液液基细胞学检查,2 mL进行脑脊液生物化学检查。 结果 使用CellSearch系统检测20例疑似肺癌脑膜患者的脑脊液,全部(100%)找到恶性肿瘤细胞;脑脊液液基细胞学法有12例(60%)找到肿瘤细胞。1例阴性对照未找到恶性肿瘤细胞。CellSearch方法与脑脊液液基细胞学比较差异有统计学意义(P=0.008)。 结论 CellSearch技术用于检测脑膜转移癌患者脑脊液里的恶性肿瘤细胞对比传统技术更有优势,可作为一种新的可靠的辅助诊断脑膜转移癌方法。

       

      Abstract: Objectives To evaluate the feasibility of using CellSearch and Circulating Tumor Cell Kit(Epithelial)to detect and count the malignant tumor cells in cerebrospinal fluid (CSF) from the lung cancer patients with leptomeningeal metastasis (LM). Methods Twenty patients with obvious clinical symptom due to LM of lung cancer and 1 patient without LM were enrolled in this study. A total of 10~15 mL of CSF were colleted with the first-time lumbar puncture. 5~7.5 mL of CSF were used to detect the number of malignant tumor cells by CellSearch method. 5~7.5 mL of CSF were used to find the tumor cells by conventional cytology. 2 mL of CSF were used for CSF routine biochemistry analysis. Results Malignant tumor cells in the CSF were found in all 20 patients with suspected lung cancer LM by CellSearch technology. The tumor cells were found in 12 patients (60%) by CSF cytology method. Malignant tumor cell was either negative in the patient as negative control. Comparison of CellSearch technology and conventional cytology technology was statistically significant(P=0.008). Conclusion The CellSearch technology seemed superior to conventional technology in terms of finding malignant tumor cells in CSF from the patients with suspected leptomeningeal metastasis, which might be a new reliable technology for the diagnosis of leptomeningeal metastasis in NSCLC.

       

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